Diane Pukajlo, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Colorado Springs, Colorado. Her current practice location is
3237 W Carefree Cir, Colorado Springs, Colorado. You can reach out to her office (for appointments etc.) via phone at
(719) 271-2496.
Diane Pukajlo is licensed to practice in Colorado (license number 09925846) 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 1982729927.
Healthcare Provider's Profile
Full Name | Diane Pukajlo |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 3237 W Carefree Cir, Colorado Springs, Colorado |
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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: 1982729927
- Provider Enumeration Date: 03/20/2007
- Last Update Date: 03/11/2019
Medicare PECOS Information:
- PECOS PAC ID: 7315345204
- Enrollment ID: I20211006003595
Medical Identifiers
Medical identifiers for Diane Pukajlo such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1982729927 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | 09925846 (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. Diane Pukajlo allows following entities to bill medicare on her behalf.
Entity Name | Sondermind Provider Network Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1760854442 PECOS PAC ID: 9537572490 Enrollment ID: O20210113002826 |
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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. Diane Pukajlo 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 |
Diane Pukajlo, LCSW 16825 Guadalupe Ct, Peyton, CO 80831-9452 Ph: (719) 482-6608 | Diane Pukajlo, LCSW 3237 W Carefree Cir, Colorado Springs, CO 80917-3004 Ph: (719) 271-2496 |
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