Dr Michael Norman Divak, PHD is a medicare enrolled "Psychologist - Clinical" provider in Canajoharie, New York. His current practice location is
66 Montgomery St Ste 2, Canajoharie, New York. You can reach out to his office (for appointments etc.) via phone at
(518) 673-6001.
Dr Michael Norman Divak is licensed to practice in New York (license number 021046-1) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1508284704.
Healthcare Provider's Profile
Full Name | Dr Michael Norman Divak |
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Gender | Male |
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Speciality | Psychologist - Clinical |
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Location | 66 Montgomery St Ste 2, Canajoharie, New York |
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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: 1508284704
- Provider Enumeration Date: 04/03/2014
- Last Update Date: 08/22/2018
Medicare PECOS Information:
- PECOS PAC ID: 9638476401
- Enrollment ID: I20160322000705
Medical Identifiers
Medical identifiers for Dr Michael Norman Divak such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1508284704 | NPI | - | NPPES |
021046 | Other | NY | LICENSE PSYCHOLGIST |
021046 | Other | NY | NEW YORK STATE OFFICE OF PROFESSION |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103TC0700X | Psychologist - Clinical | 021046-1 (New York) | 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. Dr Michael Norman Divak allows following entities to bill medicare on his behalf.
Entity Name | The Family Counseling Center Of Fulton County Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1164473831 PECOS PAC ID: 0042283335 Enrollment ID: O20040816000523 |
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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. Dr Michael Norman Divak 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 |
Dr Michael Norman Divak, PHD 66 Montgomery St Ste 2, Canajoharie, NY 13317-1212 Ph: (518) 673-6001 | Dr Michael Norman Divak, PHD 66 Montgomery St Ste 2, Canajoharie, NY 13317-1212 Ph: (518) 673-6001 |
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