Erik J Blank, is a medicare enrolled "Social Worker - Clinical" provider in Fort Collins, Colorado. His current practice location is
4856 Innovation Dr, Fort Collins, Colorado. You can reach out to his office (for appointments etc.) via phone at
(970) 494-4200.
Erik J Blank is licensed to practice in Colorado (license number SWC.0000001468) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1093342412.
Healthcare Provider's Profile
Full Name | Erik J Blank |
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Gender | Male |
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Speciality | Social Worker - Clinical |
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Location | 4856 Innovation Dr, Fort Collins, 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: 1093342412
- Provider Enumeration Date: 03/25/2020
- Last Update Date: 10/23/2024
Medicare PECOS Information:
- PECOS PAC ID: 0042659153
- Enrollment ID: I20240422001319
Medical Identifiers
Medical identifiers for Erik J Blank such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1093342412 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | ACD.0002422 (Colorado) | Secondary |
1041C0700X | Social Worker - Clinical | SWC.0000001468 (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. Erik J Blank allows following entities to bill medicare on his behalf.
Entity Name | Summitstone Health Partners |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1821552738 PECOS PAC ID: 4284527144 Enrollment ID: O20040204000768 |
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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. Erik J Blank 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 |
Erik J Blank, 4856 Innovation Dr, Fort Collins, CO 80525-5539 Ph: (970) 494-4200 | Erik J Blank, 4856 Innovation Dr, Fort Collins, CO 80525-5539 Ph: (970) 494-4200 |
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