John Devivo, is a medicare enrolled "Social Worker - Clinical" provider in Milford, Michigan. His current practice location is
120 S Main St, Suite C, Milford, Michigan. You can reach out to his office (for appointments etc.) via phone at
(248) 390-5791.
John Devivo is licensed to practice in Michigan (license number 6801046519) 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 1205175791.
Healthcare Provider's Profile
| Full Name | John Devivo |
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| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 120 S Main St, Milford, Michigan |
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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: 1205175791
- Provider Enumeration Date: 02/05/2013
- Last Update Date: 02/05/2013
Medicare PECOS Information:
- PECOS PAC ID: 8123308293
- Enrollment ID: I20220908001384
Medical Identifiers
Medical identifiers for John Devivo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1205175791 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 6801046519 (Michigan) | Secondary |
| 101YP2500X | Counselor - Professional | 6801046519 (Michigan) | Secondary |
| 1041C0700X | Social Worker - Clinical | 6801046519 (Michigan) | Primary |
| 106H00000X | Marriage & Family Therapist | 6801046519 (Michigan) | Secondary |
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. John Devivo allows following entities to bill medicare on his behalf.
| Entity Name | Downriver Mental Health Clinic Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1295866135
PECOS PAC ID: 7911995139
Enrollment ID: O20040505000533 |
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| Entity Name | Home Of New Vision |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1457565202
PECOS PAC ID: 6901032218
Enrollment ID: O20131114001859 |
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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. John Devivo 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 |
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John Devivo,
619 Mill St,
Milford, MI 48381-2270
Ph: (734) 646-3792 | John Devivo,
120 S Main St, Suite C,
Milford, MI 48381-1975
Ph: (248) 390-5791 |
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