Dr Marty P Witucki, PHD - Medicare Psychologist in Gravette, AR

Dr Marty P Witucki, PHD is a medicare enrolled "Psychologist - Clinical" provider in Gravette, Arkansas. He graduated from medical school in 1993 and has 31 years of diverse experience with area of expertise as Clinical Psychologist. He is a member of the group practice Chenal Family Therapy Plc and his current practice location is 1101 Jackson St Sw, Gravette, Arkansas. You can reach out to his office (for appointments etc.) via phone at (479) 787-5221.

Dr Marty P Witucki is licensed to practice in Arkansas (license number 16-22P) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1477587772.

Contact Information

Dr Marty P Witucki, PHD
1101 Jackson St Sw,
Gravette, AR 72736-9121
(479) 787-5221
(479) 787-5613



Healthcare Provider's Profile

Full NameDr Marty P Witucki
GenderMale
SpecialityClinical Psychologist
Experience31 Years
Location1101 Jackson St Sw, Gravette, Arkansas
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Marty P Witucki graduated from medical school in 1993
  NPI Data:
  • NPI Number: 1477587772
  • Provider Enumeration Date: 07/10/2006
  • Last Update Date: 10/16/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 5799718243
  • Enrollment ID: I20180109003432

Medical Identifiers

Medical identifiers for Dr Marty P Witucki such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1477587772NPI-NPPES
621823700MedicaidMN
18115MedicaidND

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical 263 (North Dakota)Secondary
103TC0700XPsychologist - Clinical 16-22P (Arkansas)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Ozarks Community Hospital Of GravetteGravette, ARHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Chenal Family Therapy Plc832539562728

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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 Marty P Witucki allows following entities to bill medicare on his behalf.
Entity NameSgoh Acquisition Inc
Entity TypePart B Supplier - Hospital Department(s)
Entity IdentifiersNPI Number: 1568643005
PECOS PAC ID: 5092616276
Enrollment ID: O20081016000559

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Entity NameChenal Family Therapy Plc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1356604219
PECOS PAC ID: 8325395627
Enrollment ID: O20180718000717

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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 Marty P Witucki 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
Dr Marty P Witucki, PHD
1101 Jackson St Sw,
Gravette, AR 72736-9121

Ph: (479) 787-5221
Dr Marty P Witucki, PHD
1101 Jackson St Sw,
Gravette, AR 72736-9121

Ph: (479) 787-5221

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Psychologist in Gravette, AR


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