Leticia G Vallejo, PHD - Medicare Psychologist in Fond Du Lac, WI

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Leticia G Vallejo, PHD is a medicare enrolled "Psychologist" provider in Fond Du Lac, Wisconsin. Her current practice location is 430 E Division St, Fond Du Lac, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 926-4200.

Leticia G Vallejo is licensed to practice in Wisconsin (license number 3753-57) 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 1477114304.

Contact Information

Leticia G Vallejo, PHD
430 E Division St,
Fond Du Lac, WI 54935-4560
(920) 926-4200
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameLeticia G Vallejo
GenderFemale
SpecialityPsychologist
Location430 E Division St, Fond Du Lac, Wisconsin
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1477114304
  • Provider Enumeration Date: 06/21/2019
  • Last Update Date: 01/18/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 1355776139
  • Enrollment ID: I20200124001968

Medical Identifiers

Medical identifiers for Leticia G Vallejo such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1477114304NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103T00000XPsychologist 3753-57 (Wisconsin)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. Leticia G Vallejo allows following entities to bill medicare on her behalf.
Entity NameBehavioral Solutions Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1174633119
PECOS PAC ID: 8820983760
Enrollment ID: O20040218001088
Entity NameWellqor Psychological Services Of Wisconsin, S.c.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1194252742
PECOS PAC ID: 5991073868
Enrollment ID: O20170616002275
Entity NameNew Frontiers Psychiatric Sc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003390394
PECOS PAC ID: 7416201058
Enrollment ID: O20181116001317

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. Leticia G Vallejo 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 AddressPractice Location Address
Leticia G Vallejo, PHD
5627 S 25th St,
Milwaukee, WI 53221-4219

Ph: (414) 625-0261		Leticia G Vallejo, PHD
430 E Division St,
Fond Du Lac, WI 54935-4560

Ph: (920) 926-4200

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

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