Ms Susanne Annette Short, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Jemez Springs, New Mexico. Her current practice location is
17482 Highway 4, Jemez Springs, New Mexico. You can reach out to her office (for appointments etc.) via phone at
(612) 505-2694.
Ms Susanne Annette Short is licensed to practice in New Mexico (license number 2022-0084) 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 1639349020.
Healthcare Provider's Profile
Full Name | Ms Susanne Annette Short |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 17482 Highway 4, Jemez Springs, New Mexico |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1639349020
- Provider Enumeration Date: 03/03/2008
- Last Update Date: 10/03/2022
Medicare PECOS Information:
- PECOS PAC ID: 7810352481
- Enrollment ID: I20230503003491
Medical Identifiers
Medical identifiers for Ms Susanne Annette Short such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1639349020 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | 09928374 (Colorado) | Secondary |
1041C0700X | Social Worker - Clinical | 14543 (Minnesota) | Secondary |
1041C0700X | Social Worker - Clinical | 2022-0084 (New Mexico) | 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. Ms Susanne Annette Short allows following entities to bill medicare on her behalf.
Entity Name | Sshort Counseling Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1558086967 PECOS PAC ID: 2466817036 Enrollment ID: O20230503003451 |
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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. Ms Susanne Annette Short 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 |
Ms Susanne Annette Short, LICSW Po Box 573, Jemez Springs, NM 87025-0573 Ph: (612) 505-2694 | Ms Susanne Annette Short, LICSW 17482 Highway 4, Jemez Springs, NM 87025-8702 Ph: (612) 505-2694 |
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