Autumn Marie Diller, LAC is a medicare enrolled "Social Worker" provider in St. Ignatius, Montana. Her current practice location is
1 Woodcocks Way, St. Ignatius, Montana. You can reach out to her office (for appointments etc.) via phone at
(406) 745-3525.
Autumn Marie Diller is licensed to practice in Idaho (license number LSW41996) 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 1134695091.
Healthcare Provider's Profile
| Full Name | Autumn Marie Diller |
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| Gender | Female |
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| Speciality | Social Worker |
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| Location | 1 Woodcocks Way, St. Ignatius, Montana |
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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: 1134695091
- Provider Enumeration Date: 10/18/2018
- Last Update Date: 04/07/2022
Medicare PECOS Information:
- PECOS PAC ID: 3476940313
- Enrollment ID: I20220425001277
Medical Identifiers
Medical identifiers for Autumn Marie Diller such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1134695091 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | BBH-LAC-LIC-32707 (Montana) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 32707 (Montana) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCSW-41996 (Idaho) | Secondary |
| 104100000X | Social Worker | LSW41996 (Idaho) | 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. Autumn Marie Diller allows following entities to bill medicare on her behalf.
| Entity Name | Boundary Regional Community Health Center, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1538447727
PECOS PAC ID: 2264341221
Enrollment ID: O20050211000195 |
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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. Autumn Marie Diller 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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Autumn Marie Diller, LAC
P.o. Box 880,
St. Ignatius, MT 59865
Ph: (406) 745-3525 | Autumn Marie Diller, LAC
1 Woodcocks Way,
St. Ignatius, MT 59865
Ph: (406) 745-3525 |
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