Ethan Mccormack, LICSW is a medicare enrolled "Social Worker" provider in Seattle, Washington. His current practice location is
4540 Sand Point Way Ne Ste 200, Seattle, Washington. You can reach out to his office (for appointments etc.) via phone at
(206) 987-2000.
Ethan Mccormack is licensed to practice in Washington (license number LW60626693) 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 1942612494.
Healthcare Provider's Profile
Full Name | Ethan Mccormack |
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Gender | Male |
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Speciality | Social Worker |
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Location | 4540 Sand Point Way Ne Ste 200, Seattle, Washington |
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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: 1942612494
- Provider Enumeration Date: 06/02/2014
- Last Update Date: 01/28/2022
Medicare PECOS Information:
- PECOS PAC ID: 2163719469
- Enrollment ID: I20160930000753
Medical Identifiers
Medical identifiers for Ethan Mccormack such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1942612494 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 6801094378 (Michigan) | Secondary |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | LW60626693 (Washington) | Secondary |
104100000X | Social Worker | LW60626693 (Washington) | 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. Ethan Mccormack allows following entities to bill medicare on his behalf.
Entity Name | Seattle Childrens Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1003319500 PECOS PAC ID: 9032021050 Enrollment ID: O20031211000532 |
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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. Ethan Mccormack 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 |
Ethan Mccormack, LICSW 4800 Sand Point Way Ne, Seattle, WA 98105-3901 Ph: (206) 987-2000 | Ethan Mccormack, LICSW 4540 Sand Point Way Ne Ste 200, Seattle, WA 98105-3941 Ph: (206) 987-2000 |
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