Max Smith, is a medicare enrolled "Counselor - Professional" provider in Oblong, Illinois. His current practice location is
103 W Main St Ste 6, Oblong, Illinois. You can reach out to his office (for appointments etc.) via phone at
(618) 636-0719.
Max Smith is licensed to practice in Illinois (license number 180016323) 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 1548933146.
Healthcare Provider's Profile
Full Name | Max Smith |
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Gender | Male |
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Speciality | Counselor - Professional |
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Location | 103 W Main St Ste 6, Oblong, Illinois |
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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: 1548933146
- Provider Enumeration Date: 07/29/2021
- Last Update Date: 08/23/2024
Medicare PECOS Information:
- PECOS PAC ID: 1153857693
- Enrollment ID: I20241209000299
Medical Identifiers
Medical identifiers for Max Smith such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1548933146 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YP2500X | Counselor - Professional | 178017178 (Illinois) | Secondary |
101YP2500X | Counselor - Professional | 180016323 (Illinois) | 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. Max Smith allows following entities to bill medicare on his behalf.
Entity Name | Edgewood Clinical Services P.c. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1295914646 PECOS PAC ID: 3971963901 Enrollment ID: O20230721001228 |
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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. Max Smith 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 |
Max Smith, 103 W Main St Ste 6, Oblong, IL 62449-1165 Ph: () - | Max Smith, 103 W Main St Ste 6, Oblong, IL 62449-1165 Ph: (618) 636-0719 |
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