Khamphady Keovongsa, LICSW in Arlington, MA - Medicare Social Worker Provider

Khamphady Keovongsa, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Arlington, Massachusetts. His current practice location is 30 Standish Rd, Arlington, Massachusetts. You can reach out to his office (for appointments etc.) via phone at (781) 999-4975.

Khamphady Keovongsa is licensed to practice in Utah (license number 9455497-3501) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1194125625.

Contact Information

	Khamphady Keovongsa, LICSW
	30 Standish Rd, Arlington, MA 02476-7069
	(781) 999-4975
	(801) 263-4333

Map and Direction

Healthcare Provider's Profile

Full Name	Khamphady Keovongsa
Gender	Male
Speciality	Social Worker - Clinical
Location	30 Standish Rd, Arlington, Massachusetts
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1194125625
Provider Enumeration Date: 09/03/2014
Last Update Date: 09/21/2023

Medicare PECOS Information:

PECOS PAC ID: 6305144338
Enrollment ID: I20231011003180

Medical Identifiers

Medical identifiers for Khamphady Keovongsa such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1194125625	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	9455497-3501 (Utah)	Primary
1041C0700X	Social Worker - Clinical	9455497-3502 (Utah)	Secondary

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. Khamphady Keovongsa allows following entities to bill medicare on his behalf.

Entity Name	Actualize Counseling & Nutrition Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316571136 PECOS PAC ID: 2567815400 Enrollment ID: O20240127000165

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. Khamphady Keovongsa 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
Khamphady Keovongsa, LICSW 30 Standish Rd, Arlington, MA 02476-7069 Ph: (781) 999-4975	Khamphady Keovongsa, LICSW 30 Standish Rd, Arlington, MA 02476-7069 Ph: (781) 999-4975

Reviews and Comments

Social Worker in Arlington, MA

Mr. Thomas Arthus Denton, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 259 Massachusetts Ave, Arlington, MA 02474 Phone: 781-643-5451
Ms. Katharine Elliott Mayers, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 22 Mill St, Ste 306, Arlington, MA 02476 Phone: 781-643-0610 Fax: 781-643-0609
Ms. Katherine Alison Hadden, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 198 Sylvia St, Arlington, MA 02476 Phone: 202-904-7645
Monica Belinda Prudencio, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 670r Massachusetts Ave, Arlington, MA 02476 Phone: 781-316-3255 Fax: 781-316-3261
Ms. Kathryn Gross Coletta, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 7 Mystic St, Suite 200, Arlington, MA 02474 Phone: 617-671-5341
Renee Lubowich, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6 Kilsythe Rd, Arlington, MA 02476 Phone: 781-643-1959
Mr. Amos Tingley Worth, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 927 Massachusetts Ave Ste 3, Arlington, MA 02476 Phone: 617-460-1981

Khamphady Keovongsa, LICSW - Medicare Clinical Social Worker in Arlington, MA