Theresa Jacklin, LCSW in Bellerose, NY - Medicare Social Worker Provider

Theresa Jacklin, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Bellerose, New York. Her current practice location is 8543 250th St, Bellerose, New York. You can reach out to her office (for appointments etc.) via phone at (646) 201-1972.

Theresa Jacklin is licensed to practice in New York (license number 088299) 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 1063820066.

Contact Information

	Theresa Jacklin, LCSW
	8543 250th St, Bellerose, NY 11426-2110
	(646) 201-1972
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Theresa Jacklin
Gender	Female
Speciality	Social Worker - Clinical
Location	8543 250th St, Bellerose, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1063820066
Provider Enumeration Date: 07/23/2014
Last Update Date: 02/06/2023

Medicare PECOS Information:

PECOS PAC ID: 0648559914
Enrollment ID: I20161110000283

Medical Identifiers

Medical identifiers for Theresa Jacklin such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063820066	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	088299 (New York)	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. Theresa Jacklin allows following entities to bill medicare on her behalf.

Entity Name	North Shore - Lij Medical Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1053688572 PECOS PAC ID: 3375701568 Enrollment ID: O20120220000262

Entity Name	North Shore-lij Medical Group Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1942666557 PECOS PAC ID: 3971878901 Enrollment ID: O20171002001431

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. Theresa Jacklin 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
Theresa Jacklin, LCSW 600 Community Dr Ste 400, Manhasset, NY 11030-3818 Ph: (646) 201-1972	Theresa Jacklin, LCSW 8543 250th St, Bellerose, NY 11426-2110 Ph: (646) 201-1972

Reviews and Comments

Social Worker in Bellerose, NY

Mr. Philip Stronger, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 251 15 71st Avenue, Bellerose, NY 11426 Phone: 917-655-1108 Fax: 718-831-1656
Carol Odette, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 8633 251st St, Bellerose, NY 11426 Phone: 718-347-1907
Mr. John Richard Holmes, LCSW-R Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 7403 Commonwealth Blvd, Bellerose, NY 11426 Phone: 718-264-4578 Fax: 718-264-4939
Mrs. Lorna Sharon Erdelyi, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 7403 Commonwealth Blvd, Bellerose, NY 11426 Phone: 718-264-4539
Carlos S Lara, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 8804 Commonwealth Blvd, Bellerose, NY 11426 Phone: 914-939-8935 Fax: 718-312-0730
Hannah Rose Mitchell, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 24912 Elkmont Ave, Bellerose, NY 11426 Phone: 540-905-5345

Theresa Jacklin, LCSW - Medicare Clinical Social Worker in Bellerose, NY