Dominique Shabazz, in Hartford, CT - Medicare Social Worker Provider

Dominique Shabazz, is a medicare enrolled "Social Worker - Clinical" provider in Hartford, Connecticut. Her current practice location is 660 Prospect Ave, Hartford, Connecticut. You can reach out to her office (for appointments etc.) via phone at (860) 778-0266.

Dominique Shabazz is licensed to practice in Connecticut (license number 101973) 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 1154808855.

Contact Information

	Dominique Shabazz,
	660 Prospect Ave, Hartford, CT 06105-4230
	(860) 778-0266
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dominique Shabazz
Gender	Female
Speciality	Social Worker - Clinical
Location	660 Prospect Ave, Hartford, Connecticut
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1154808855
Provider Enumeration Date: 07/25/2018
Last Update Date: 07/25/2018

Medicare PECOS Information:

PECOS PAC ID: 7416325162
Enrollment ID: I20221130001650

Medical Identifiers

Medical identifiers for Dominique Shabazz such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1154808855	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	101973 (Connecticut)	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. Dominique Shabazz allows following entities to bill medicare on her behalf.

Entity Name	State Of Connecticut
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1487689022 PECOS PAC ID: 8022915677 Enrollment ID: O20040319000169

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. Dominique Shabazz 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
Dominique Shabazz, 40 Court St, Windsor, CT 06095-2909 Ph: () -	Dominique Shabazz, 660 Prospect Ave, Hartford, CT 06105-4230 Ph: (860) 778-0266

Reviews and Comments

Social Worker in Hartford, CT

Mr. Glenn Gregory Gemma, L.C.S.W. Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 555 Franklin Ave, Hartford, CT 06114 Phone: 860-756-8669
Laurel Barrett, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 331 Wethersfield Ave, Hartford, CT 06114 Phone: 860-971-4761
Isabella Pugliese, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 553 Farmington Ave, Hartford, CT 06105 Phone: 206-819-8258
Maryellen Thomson Sciallo, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1680 Albany Ave, Hartford, CT 06105 Phone: 860-236-4511
Charlene Ann Snipes, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 500 Vine Street, Hartford, CT 06112 Phone: 860-297-0905 Fax: 860-297-0914
Mr. David Susanin, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 500 Vine St, Hartford, CT 06112 Phone: 860-297-0810 Fax: 860-293-6356
Ms. Rebecca Jennifer Robotham, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 65 Osten Blvd, Hartford, CT 06106 Phone: 860-729-2069

Dominique Shabazz, - Medicare Clinical Social Worker in Hartford, CT