Mrs Jamie Tisa Coffey-kelly, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Cascade, Idaho. 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 Cascade Medical Center Hospital District and her current practice location is
402 Lake Cascade Pkwy, Cascade, Idaho. You can reach out to her office (for appointments etc.) via phone at
(208) 382-4285.
Mrs Jamie Tisa Coffey-kelly is licensed to practice in Idaho (license number LCSW-37639) 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 1992135818.
Healthcare Provider's Profile
| Full Name | Mrs Jamie Tisa Coffey-kelly |
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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 | 402 Lake Cascade Pkwy, Cascade, Idaho |
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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:
- Mrs Jamie Tisa Coffey-kelly graduated from medical school in 2012
NPI Data:
- NPI Number: 1992135818
- Provider Enumeration Date: 11/13/2013
- Last Update Date: 02/22/2021
Medicare PECOS Information:
- PECOS PAC ID: 5597020842
- Enrollment ID: I20180607001888
Medical Identifiers
Medical identifiers for Mrs Jamie Tisa Coffey-kelly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1992135818 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 1041C0700X | Social Worker - Clinical | LCSW-37639 (Idaho) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Cascade Medical Center Hospital District | 6103739719 | 7 |
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 Jamie Tisa Coffey-kelly allows following entities to bill medicare on her behalf.
| Entity Name | Glenns Ferry Health Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376673137
PECOS PAC ID: 5496656894
Enrollment ID: O20040119000307 |
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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. Mrs Jamie Tisa Coffey-kelly 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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Mrs Jamie Tisa Coffey-kelly, LCSW
Po Box 1330,
Cascade, ID 83611-1330
Ph: (208) 382-4285 | Mrs Jamie Tisa Coffey-kelly, LCSW
402 Lake Cascade Pkwy,
Cascade, ID 83611-7702
Ph: (208) 382-4285 |
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