Dr Maureen Tara Nickerson, PSYD - Medicare Psychologist in Medical Lake, WA

Dr Maureen Tara Nickerson, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Medical Lake, Washington. Her current practice location is 850 W. Maple St., Medical Lake, Washington. You can reach out to her office (for appointments etc.) via phone at (509) 565-4000.

Dr Maureen Tara Nickerson is licensed to practice in Washington (license number PY60778414) 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 1578130274.

Contact Information

Dr Maureen Tara Nickerson, PSYD
850 W. Maple St.,
Medical Lake, WA 99022
(509) 565-4000
Not Available



Healthcare Provider's Profile

Full NameDr Maureen Tara Nickerson
GenderFemale
SpecialityPsychologist - Clinical
Location850 W. Maple St., Medical Lake, Washington
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1578130274
  • Provider Enumeration Date: 06/10/2021
  • Last Update Date: 06/10/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 5395127989
  • Enrollment ID: I20220728002752

Medical Identifiers

Medical identifiers for Dr Maureen Tara Nickerson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1578130274NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical PY60778414 (Washington)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 Maureen Tara Nickerson allows following entities to bill medicare on her behalf.
Entity NameDepartment Of Social Dept Of Shs Div Of Instns
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1467440602
PECOS PAC ID: 9133013725
Enrollment ID: O20040213000028

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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 Maureen Tara Nickerson 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 Maureen Tara Nickerson, PSYD
P.o. Box 800, 850 W. Maple St.,
Medical Lake, WA 99022

Ph: () -
Dr Maureen Tara Nickerson, PSYD
850 W. Maple St.,
Medical Lake, WA 99022

Ph: (509) 565-4000

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Psychologist in Medical Lake, WA

Dr. Darlene E. Walsh-martin, PHD
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 850 Maple Street, Eastern State Hospital, Medical Lake, WA 99022
Phone: 509-565-4000    Fax: 509-565-4705
Christina L. Zampich, PSYD
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 850 Maple Street, Medical Lake, WA 99022
Phone: 509-565-4000    Fax: 509-565-7015
Dr. Patricia L. Gunderson, PHD
Psychologist
Medicare: Medicare Enrolled
Practice Location: 850 Maple Street, Medical Lake, WA 99022
Phone: 509-565-4000    Fax: 509-565-7015
Lisa Mathews,
Psychologist
Medicare: Medicare Enrolled
Practice Location: 850 W. Maple St., Medical Lake, WA 99022
Phone: 509-565-4000    Fax: 509-565-4705
Dr. Gretchen L. Meader, PHD
Psychologist
Medicare: Medicare Enrolled
Practice Location: 850 Maple St., Medical Lake, WA 99022
Phone: 509-565-4000    Fax: 509-565-4705
Dr. Alton J Couturier, PHD
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 800 West Maple Street, Medical Lake, WA 99022
Phone: 509-299-3121    Fax: 509-299-7015
David W. Elkins Jr., PHD
Psychologist
Medicare: Medicare Enrolled
Practice Location: 850 Maple Street, Eastern State Hospital, Medical Lake, WA 99022
Phone: 509-565-4000    Fax: 509-565-4705

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