Jaylea Black, is a medicare enrolled "Social Worker - Clinical" provider in Hays, Kansas. Her current practice location is
4320 Vine Street, Unit 80 - Pmb 191, Hays, Kansas. You can reach out to her office (for appointments etc.) via phone at
(785) 734-0292.
Jaylea Black is licensed to practice in Kansas (license number 05319) 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 1285127530.
Healthcare Provider's Profile
| Full Name | Jaylea Black |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 4320 Vine Street, Hays, Kansas |
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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: 1285127530
- Provider Enumeration Date: 06/12/2018
- Last Update Date: 03/11/2024
Medicare PECOS Information:
- PECOS PAC ID: 2163869892
- Enrollment ID: I20240318001706
Medical Identifiers
Medical identifiers for Jaylea Black such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1285127530 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 752 (Kansas) | Secondary |
| 1041C0700X | Social Worker - Clinical | CSW.09927568 (Colorado) | Secondary |
| 1041C0700X | Social Worker - Clinical | 05319 (Kansas) | 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. Jaylea Black allows following entities to bill medicare on her behalf.
| Entity Name | Hays Medical Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1770618258
PECOS PAC ID: 1557279676
Enrollment ID: O20040224000687 |
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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. Jaylea Black 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 |
|---|
Jaylea Black,
4320 Vine Street, Unit 80 - Pmb 191,
Hays, KS 67601-3551
Ph: (785) 734-0292 | Jaylea Black,
4320 Vine Street, Unit 80 - Pmb 191,
Hays, KS 67601-3551
Ph: (785) 734-0292 |
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