Marisa Bassett De La Garza, MSW, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Fayetteville, New York. Her current practice location is
217 Highbridge St Apt 9, Fayetteville, New York. You can reach out to her office (for appointments etc.) via phone at
(206) 375-4421.
Marisa Bassett De La Garza is licensed to practice in New York (license number 084302-1) 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 1699832576.
Healthcare Provider's Profile
Full Name | Marisa Bassett De La Garza |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 217 Highbridge St Apt 9, Fayetteville, New York |
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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: 1699832576
- Provider Enumeration Date: 01/02/2007
- Last Update Date: 08/17/2016
Medicare PECOS Information:
- PECOS PAC ID: 4789963380
- Enrollment ID: I20161123001046
Medical Identifiers
Medical identifiers for Marisa Bassett De La Garza such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1699832576 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YP2500X | Counselor - Professional | RC00047900 (Washington) | Secondary |
1041C0700X | Social Worker - Clinical | 084302-1 (New York) | 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. Marisa Bassett De La Garza allows following entities to bill medicare on her behalf.
Entity Name | Psychological Healthcare Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1922109578 PECOS PAC ID: 7416860572 Enrollment ID: O20040317000828 |
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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. Marisa Bassett De La Garza 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 |
Marisa Bassett De La Garza, MSW, LCSW 217 Highbridge St Apt 9, Fayetteville, NY 13066-1967 Ph: (206) 375-4421 | Marisa Bassett De La Garza, MSW, LCSW 217 Highbridge St Apt 9, Fayetteville, NY 13066-1967 Ph: (206) 375-4421 |
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