Mary Lyn Whitaker, in Fairfield, CA - Medicare Speech-Language Pathologist Provider

Mary Lyn Whitaker, is a medicare enrolled "Speech-language Pathologist" provider in Fairfield, California. Her current practice location is 1860 Pennsylvania Ave Ste 305, Fairfield, California. You can reach out to her office (for appointments etc.) via phone at (707) 646-4333.

Mary Lyn Whitaker is licensed to practice in California (license number 35331) 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 1932666849.

Contact Information

	Mary Lyn Whitaker,
	1860 Pennsylvania Ave Ste 305, Fairfield, CA 94533-3550
	(707) 646-4333
	(707) 646-4833

Map and Direction

Healthcare Provider's Profile

Full Name	Mary Lyn Whitaker
Gender	Female
Speciality	Speech-language Pathologist
Location	1860 Pennsylvania Ave Ste 305, Fairfield, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1932666849
Provider Enumeration Date: 02/27/2019
Last Update Date: 09/29/2025

Medicare PECOS Information:

PECOS PAC ID: 8224474697
Enrollment ID: I20240307001600

Medical Identifiers

Medical identifiers for Mary Lyn Whitaker such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1932666849	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
235Z00000X	Speech-language Pathologist	35331 (California)	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. Mary Lyn Whitaker allows following entities to bill medicare on her behalf.

Provider Name	Northbay Healthcare Group
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1821147786 PECOS PAC ID: 0042122244 Enrollment ID: O20031105000409

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. Mary Lyn Whitaker 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
Mary Lyn Whitaker, 36000 Fremont Blvd Apt 167, Fremont, CA 94536-3472 Ph: (831) 402-9652	Mary Lyn Whitaker, 1860 Pennsylvania Ave Ste 305, Fairfield, CA 94533-3550 Ph: (707) 646-4333

Reviews and Comments

Speech-Language Pathologist in Fairfield, CA

Lauren Denise Smith, CFY-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2100 W Texas St Apt 39, Fairfield, CA 94533 Phone: 480-201-7329
Unity Therapies Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 707 Kentucky St, Fairfield, CA 94533 Phone: 707-759-3716
Proficio Speech Therapy Group, Inc. Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1005 Westchester Ct, Fairfield, CA 94533 Phone: 707-344-1771
Fernanda Astudillo, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3020 Beechwood Ct, Fairfield, CA 94533 Phone: 707-720-9519
Mrs. Susvir T Sahota, MSCCSLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2800 Estates Dr, Fairfield, CA 94533 Phone: 707-432-1218
Sneha Susan Jacob, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3965 Shaker Run Cir, Fairfield, CA 94533 Phone: 917-415-1629
Nnenna Perkins, M.S. CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3336 N Texas St, Suite J309, Fairfield, CA 94533 Phone: 707-718-4162

Mary Lyn Whitaker, - Medicare Speech-Language Pathologist in Fairfield, CA