Kristin Elizabeth Maple, PH D is a medicare enrolled "Clinical Neuropsychologist" provider in Medford, Oregon. Her current practice location is
837 Alder Creek Dr, Medford, Oregon. You can reach out to her office (for appointments etc.) via phone at
(541) 608-3878.
Kristin Elizabeth Maple is licensed to practice in Oregon (license number 3428) 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 1174290415.
Healthcare Provider's Profile
| Full Name | Kristin Elizabeth Maple |
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| Gender | Female |
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| Speciality | Clinical Neuropsychologist |
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| Location | 837 Alder Creek Dr, Medford, Oregon |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1174290415
- Provider Enumeration Date: 08/25/2021
- Last Update Date: 08/25/2021
Medicare PECOS Information:
- PECOS PAC ID: 6305242934
- Enrollment ID: I20210908000943
Medical Identifiers
Medical identifiers for Kristin Elizabeth Maple such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1174290415 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 103TC0700X | Psychologist - Clinical | 3428 (Oregon) | Secondary |
| 103G00000X | Clinical Neuropsychologist | 3428 (Oregon) | 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. Kristin Elizabeth Maple allows following entities to bill medicare on her behalf.
| Entity Name | Southern Oregon Neuropsychological Clinic Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1588726939 PECOS PAC ID: 8729050877 Enrollment ID: O20040809001385 |
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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. Kristin Elizabeth Maple 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 |
Kristin Elizabeth Maple, PH D 837 Alder Creek Dr, Medford, OR 97504-8900 Ph: (541) 608-3878 | Kristin Elizabeth Maple, PH D 837 Alder Creek Dr, Medford, OR 97504-8900 Ph: (541) 608-3878 |
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