Marly Ayala-icaza, MH14786 in Bradenton, FL - Medicare Counselor Provider

Marly Ayala-icaza, MH14786 is a medicare enrolled "Counselor - Mental Health" provider in Bradenton, Florida. Her current practice location is 3500 El Conquistador Pkwy Apt 259, Apt 259, Bradenton, Florida. You can reach out to her office (for appointments etc.) via phone at (954) 806-3698.

Marly Ayala-icaza is licensed to practice in Florida (license number IMH2387) 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 1821412230.

Contact Information

	Marly Ayala-icaza, MH14786
	3500 El Conquistador Pkwy Apt 259, Apt 259, Bradenton, FL 34210-3819
	(954) 806-3698
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Marly Ayala-icaza
Gender	Female
Speciality	Counselor - Mental Health
Location	3500 El Conquistador Pkwy Apt 259, Bradenton, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1821412230
Provider Enumeration Date: 02/06/2014
Last Update Date: 02/05/2018

Medicare PECOS Information:

PECOS PAC ID: 5890227755
Enrollment ID: I20241016002626

Medical Identifiers

Medical identifiers for Marly Ayala-icaza such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1821412230	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	IMH2387 (Florida)	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. Marly Ayala-icaza allows following entities to bill medicare on her behalf.

Entity Name	Optum Behavioral Care Of North Carolina Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1033984448 PECOS PAC ID: 5092120030 Enrollment ID: O20240401000110

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. Marly Ayala-icaza 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
Marly Ayala-icaza, MH14786 3500 El Conquistador Pkwy Apt 259, Apt 259, Bradenton, FL 34210-3819 Ph: (954) 806-3698	Marly Ayala-icaza, MH14786 3500 El Conquistador Pkwy Apt 259, Apt 259, Bradenton, FL 34210-3819 Ph: (954) 806-3698

Reviews and Comments

Counselor in Bradenton, FL

Lisa M Davis, L.M.H.C., PH.D. Counselor Medicare: Not Enrolled in Medicare Practice Location: 351 6th Ave W, Bradenton, FL 34205 Phone: 941-737-8897
Jessica Lynn Gomez, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 9030 58th Dr E, Bradenton, FL 34202 Phone: 941-567-6207
Mrs. Susan Tabicman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 6400 Manatee Ave W, Bradenton, FL 34209 Phone: 941-704-9688
Mr. Nestor Levesque, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 379 6th Ave W, Bradenton, FL 34205 Phone: 941-782-4150 Fax: 941-782-4101
Mrs. Virginia D Whittington, MSW Counselor Medicare: Accepting Medicare Assignments Practice Location: 2328 Manatee Ave W, Bradenton, FL 34205 Phone: 941-708-0896 Fax: 941-747-1696
Ms. Lorraine Ann Emmer, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 379 6th Ave W, Bradenton, FL 34205 Phone: 941-782-4100
Mrs. Halle Kranz, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 239 301 Blvd W, Bradenton, FL 34205 Phone: 941-741-3023

Marly Ayala-icaza, MH14786 - Medicare Counselor in Bradenton, FL