Ellinor R Burke, PHD is a medicare enrolled "Psychologist" provider in Saint Marys, Georgia. Her current practice location is
1201 Shadowlawn Dr Ste 101, Saint Marys, Georgia. You can reach out to her office (for appointments etc.) via phone at
(912) 744-0993.
Ellinor R Burke is licensed to practice in Georgia (license number PSY003747) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1821095399.
Healthcare Provider's Profile
| Full Name | Ellinor R Burke |
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| Gender | Female |
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| Speciality | Psychologist |
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| Location | 1201 Shadowlawn Dr Ste 101, Saint Marys, Georgia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1821095399
- Provider Enumeration Date: 06/30/2005
- Last Update Date: 07/01/2020
Medicare PECOS Information:
- PECOS PAC ID: 3870535586
- Enrollment ID: I20140902001338
Medical Identifiers
Medical identifiers for Ellinor R Burke such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1821095399 | NPI | - | NPPES |
| 6248306 | Medicaid | NJ | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | PSY003747 (New Jersey) | Secondary |
| 103T00000X | Psychologist | 35SI00313400 (New Jersey) | Secondary |
| 103T00000X | Psychologist | PSY003747 (Georgia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ellinor R Burke allows following entities to bill medicare on her behalf.
| Entity Name | Grow Healthcare Group Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1245845932
PECOS PAC ID: 3476961368
Enrollment ID: O20220315000829 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ellinor R Burke is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ellinor R Burke, PHD
Po Box 5099,
Saint Marys, GA 31558-5099
Ph: (912) 882-3662 | Ellinor R Burke, PHD
1201 Shadowlawn Dr Ste 101,
Saint Marys, GA 31558-4074
Ph: (912) 744-0993 |
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