Kristin M Brock, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Newkirk, Oklahoma. She graduated from medical school in 2012 and has 12 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Fairfax Medical Facilities Inc and her current practice location is
716 S Highway 77, Newkirk, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(580) 362-2555.
Kristin M Brock is licensed to practice in Oklahoma (license number 3832) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1780949883.
Healthcare Provider's Profile
| Full Name | Kristin M Brock |
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| Gender | Female |
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| Speciality | Clinical Social Worker |
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| Experience | 12 Years |
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| Location | 716 S Highway 77, Newkirk, Oklahoma |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Kristin M Brock graduated from medical school in 2012
NPI Data:
- NPI Number: 1780949883
- Provider Enumeration Date: 07/05/2012
- Last Update Date: 07/21/2022
Medicare PECOS Information:
- PECOS PAC ID: 6002055738
- Enrollment ID: I20130610000483
Medical Identifiers
Medical identifiers for Kristin M Brock such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1780949883 | NPI | - | NPPES |
| 200446140A | Medicaid | OK | |
| 287620YRHZ | Other | OK | MEDICARE PTAN |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 1041C0700X | Social Worker - Clinical | 3832 (Oklahoma) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Fairfax Medical Facilities Inc | 4284663360 | 16 |
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. Kristin M Brock allows following entities to bill medicare on her behalf.
| Entity Name | Community Pathways Unlimited Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1659328284
PECOS PAC ID: 6608776349
Enrollment ID: O20040109001005 |
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| Entity Name | Fairfax Medical Facilities Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1538183173
PECOS PAC ID: 4284663360
Enrollment ID: O20060209000250 |
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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. Kristin M Brock 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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Kristin M Brock, LCSW
212 N Main St,
Fairfax, OK 74637-3023
Ph: (918) 642-3100 | Kristin M Brock, LCSW
716 S Highway 77,
Newkirk, OK 74647-7009
Ph: (580) 362-2555 |
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