Ayesha Mohamed Ali, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Bend, Oregon. Her current practice location is
63311 Jamison St, Bend, Oregon. You can reach out to her office (for appointments etc.) via phone at
(541) 322-7500.
Ayesha Mohamed Ali is licensed to practice in Oregon (license number L10972) 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 1770140881.
Healthcare Provider's Profile
| Full Name | Ayesha Mohamed Ali |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 63311 Jamison St, Bend, Oregon |
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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: 1770140881
- Provider Enumeration Date: 05/23/2019
- Last Update Date: 05/16/2022
Medicare PECOS Information:
- PECOS PAC ID: 2365820131
- Enrollment ID: I20220607001547
Medical Identifiers
Medical identifiers for Ayesha Mohamed Ali such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1770140881 | NPI | - | NPPES |
| STB-A-10184107 | Other | OR | CERTIFIED ASSOCIATE SEX OFFENDER THERAPIST |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | 084586 (Oregon) | Secondary |
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | L10972 (Oregon) | 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. Ayesha Mohamed Ali allows following entities to bill medicare on her behalf.
| Entity Name | Deschutes County Oregon |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1235172180
PECOS PAC ID: 9638083371
Enrollment ID: O20031117000568 |
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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. Ayesha Mohamed Ali 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 |
|---|
Ayesha Mohamed Ali, LCSW
2577 Ne Courtney Dr,
Bend, OR 97701-7752
Ph: (541) 322-7500 | Ayesha Mohamed Ali, LCSW
63311 Jamison St,
Bend, OR 97703-8288
Ph: (541) 322-7500 |
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