Carrie A Burris, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Ray, North Dakota. Her current practice location is
24 W Railroad Ave Suite 16, Ray, North Dakota. You can reach out to her office (for appointments etc.) via phone at
(701) 568-5600.
Carrie A Burris is licensed to practice in North Dakota (license number 5619) 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 1053758300.
Healthcare Provider's Profile
| Full Name | Carrie A Burris |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 24 W Railroad Ave Suite 16, Ray, North Dakota |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1053758300
- Provider Enumeration Date: 05/28/2013
- Last Update Date: 05/21/2019
Medicare PECOS Information:
- PECOS PAC ID: 6709121940
- Enrollment ID: I20181217002724
Medical Identifiers
Medical identifiers for Carrie A Burris such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1053758300 | NPI | - | NPPES |
| 5619 | Other | ND | ND BOARD OF SW EXAMINERS |
| LCSW-35774 | Other | ID | ID BUREAU OF OCCUPATIONAL LICENSES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1041C0700X | Social Worker - Clinical | LCSW-35774 (Idaho) | Secondary |
| 1041C0700X | Social Worker - Clinical | 5619 (North Dakota) | 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. Carrie A Burris allows following entities to bill medicare on her behalf.
| Entity Name | Northwest Human Service Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1770524613
PECOS PAC ID: 4183683196
Enrollment ID: O20041006000330 |
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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. Carrie A Burris 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 |
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Carrie A Burris, LICSW
1500 14th St W Ste 290,
Williston, ND 58801-4078
Ph: (701) 334-6442 | Carrie A Burris, LICSW
24 W Railroad Ave Suite 16,
Ray, ND 58849
Ph: (701) 568-5600 |
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