Mrs Ayesha Aqueelah Thomas, LCSW in Leesburg, GA - Medicare Social Worker Provider

Mrs Ayesha Aqueelah Thomas, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Leesburg, Georgia. Her current practice location is 148 Belmont Dr, Leesburg, Georgia. You can reach out to her office (for appointments etc.) via phone at (203) 551-7301.

Mrs Ayesha Aqueelah Thomas is licensed to practice in Georgia (license number CSW007458) 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 1760054902.

Contact Information

	Mrs Ayesha Aqueelah Thomas, LCSW
	148 Belmont Dr, Leesburg, GA 31763
	(203) 551-7301
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Ayesha Aqueelah Thomas
Gender	Female
Speciality	Social Worker - Clinical
Location	148 Belmont Dr, Leesburg, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1760054902
Provider Enumeration Date: 07/16/2021
Last Update Date: 07/16/2021

Medicare PECOS Information:

PECOS PAC ID: 5799181004
Enrollment ID: I20210913001897

Medical Identifiers

Medical identifiers for Mrs Ayesha Aqueelah Thomas such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1760054902	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	CSW007458 (Georgia)	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. Mrs Ayesha Aqueelah Thomas allows following entities to bill medicare on her behalf.

Entity Name	The Southeast Permanente Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1245266956 PECOS PAC ID: 6204829013 Enrollment ID: O20040407000370

Entity Name	Grow Healthcare Group Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220315000829

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. Mrs Ayesha Aqueelah Thomas 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
Mrs Ayesha Aqueelah Thomas, LCSW 137b Commerce Ave Ste 262, Lagrange, GA 30241-2337 Ph: (203) 551-7301	Mrs Ayesha Aqueelah Thomas, LCSW 148 Belmont Dr, Leesburg, GA 31763 Ph: (203) 551-7301

Reviews and Comments

Social Worker in Leesburg, GA

Mrs. Stephanie Wilder Davidson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 133 Willow Lake Dr, Leesburg, GA 31763 Phone: 229-886-8497
Tabitha Smith, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 165 Cedric St, Leesburg, GA 31763 Phone: 229-405-1900 Fax: 229-304-4486
Ms. Irina Soboleva-tippett, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 119 Beowulf Ln, Leesburg, GA 31763 Phone: 229-854-4867

Mrs Ayesha Aqueelah Thomas, LCSW - Medicare Clinical Social Worker in Leesburg, GA