Nicole Dallas, is a medicare enrolled "Social Worker - Clinical" provider in Ghent, New York. Her current practice location is
586 County Route 9, Ghent, New York. You can reach out to her office (for appointments etc.) via phone at
(518) 965-2648.
Nicole Dallas is licensed to practice in Delaware (license number Q1-0012293) 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 1306522578.
Healthcare Provider's Profile
Full Name | Nicole Dallas |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 586 County Route 9, Ghent, New York |
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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: 1306522578
- Provider Enumeration Date: 06/23/2023
- Last Update Date: 06/23/2023
Medicare PECOS Information:
- PECOS PAC ID: 1759745235
- Enrollment ID: I20230918000393
Medical Identifiers
Medical identifiers for Nicole Dallas such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1306522578 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | Q1-0012293 (Delaware) | 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. Nicole Dallas allows following entities to bill medicare on her behalf.
Entity Name | Survivors Of Abuse In Recovery Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1154386696 PECOS PAC ID: 1850294067 Enrollment ID: O20040127000770 |
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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. Nicole Dallas 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 |
Nicole Dallas, 586 County Route 9, Ghent, NY 12075-2312 Ph: (518) 965-2648 | Nicole Dallas, 586 County Route 9, Ghent, NY 12075-2312 Ph: (518) 965-2648 |
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