Amber Ivanova, LCSW, LAC is a medicare enrolled "Social Worker - Clinical" provider in Boulder, Colorado. Her current practice location is
2525 13th St Ste 200, Boulder, Colorado. You can reach out to her office (for appointments etc.) via phone at
(303) 449-6050.
Amber Ivanova is licensed to practice in Colorado (license number CSW.09925143) 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 1063917862.
Healthcare Provider's Profile
| Full Name | Amber Ivanova |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 2525 13th St Ste 200, Boulder, Colorado |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1063917862
- Provider Enumeration Date: 03/26/2018
- Last Update Date: 05/14/2021
Medicare PECOS Information:
- PECOS PAC ID: 3173878469
- Enrollment ID: I20180608000503
Medical Identifiers
Medical identifiers for Amber Ivanova such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1063917862 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | ACD.0000931 (Colorado) | Secondary |
| 1041C0700X | Social Worker - Clinical | CSW.09925143 (Colorado) | 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. Amber Ivanova allows following entities to bill medicare on her behalf.
| Entity Name | Clinica Campesina Family Health Services |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1225025406
PECOS PAC ID: 7315850484
Enrollment ID: O20031106000276 |
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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. Amber Ivanova 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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Amber Ivanova, LCSW, LAC
1735 S Public Rd Ste 203,
Lafayette, CO 80026-7093
Ph: (303) 665-3036 | Amber Ivanova, LCSW, LAC
2525 13th St Ste 200,
Boulder, CO 80304-4104
Ph: (303) 449-6050 |
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