Kristine A Petlick, in Stevensville, MI - Medicare Psychologist Provider

Kristine A Petlick, is a medicare enrolled "Psychologist" provider in Stevensville, Michigan. Her current practice location is 5675 Fairview St, Stevensville, Michigan. You can reach out to her office (for appointments etc.) via phone at (269) 429-7727.

Kristine A Petlick is licensed to practice in Michigan (license number 6361005132) 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 1144499864.

Contact Information

	Kristine A Petlick,
	5675 Fairview St, Stevensville, MI 49127-1033
	(269) 429-7727
	(269) 429-5754

Map and Direction

Healthcare Provider's Profile

Full Name	Kristine A Petlick
Gender	Female
Speciality	Psychologist
Location	5675 Fairview St, Stevensville, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1144499864
Provider Enumeration Date: 02/27/2008
Last Update Date: 01/13/2025

Medicare PECOS Information:

PECOS PAC ID: 5890223671
Enrollment ID: I20250109003392

Medical Identifiers

Medical identifiers for Kristine A Petlick such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1144499864	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	6301013815 (Michigan)	Secondary
103T00000X	Psychologist	6361005132 (Michigan)	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. Kristine A Petlick allows following entities to bill medicare on her behalf.

Entity Name	Lakeland Hospitals At Niles And St Joseph Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1134220031 PECOS PAC ID: 7517929037 Enrollment ID: O20041027001172

Entity Name	Lakeland Medical Practices
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1538397120 PECOS PAC ID: 1658427042 Enrollment ID: O20090928000216

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. Kristine A Petlick 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
Kristine A Petlick, 5675 Fairview St, Stevensville, MI 49127-1033 Ph: (269) 429-7727	Kristine A Petlick, 5675 Fairview St, Stevensville, MI 49127-1033 Ph: (269) 429-7727

Reviews and Comments

Psychologist in Stevensville, MI

Denise G Durak, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 7889 Red Arrow Hwy, Stevensville, MI 49127 Phone: 269-465-4000 Fax: 269-465-4001
Matthew Francis Benoit, TLLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5675 Fairview St, Stevensville, MI 49127 Phone: 269-429-7727
Mary Frank, PSYCHOLOGIST Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5675 Fairview St, Stevensville, MI 49127 Phone: 269-429-7727 Fax: 269-429-5754
Robert K Mcintyre, LLP NCC Psychologist Medicare: Not Enrolled in Medicare Practice Location: 7889 Red Arrow Hwy, Stevensville, MI 49127 Phone: 269-465-4000 Fax: 269-465-4001

Kristine A Petlick, - Medicare Psychologist in Stevensville, MI