Mellissa Teresa Bonilla, LCSW is a medicare enrolled "Social Worker - Clinical" provider in San Francisco, California. Her current practice location is
1001 Potrero Ave, Ward 93, San Francisco, California. You can reach out to her office (for appointments etc.) via phone at
(415) 206-8412.
Mellissa Teresa Bonilla is licensed to practice in California (license number LCSW79897) 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 1952559825.
Healthcare Provider's Profile
| Full Name | Mellissa Teresa Bonilla |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 1001 Potrero Ave, San Francisco, California |
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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: 1952559825
- Provider Enumeration Date: 09/04/2008
- Last Update Date: 10/13/2022
Medicare PECOS Information:
- PECOS PAC ID: 8325415714
- Enrollment ID: I20221027000664
Medical Identifiers
Medical identifiers for Mellissa Teresa Bonilla such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1952559825 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 104100000X | Social Worker | 35973 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCSW79897 (California) | 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. Mellissa Teresa Bonilla allows following entities to bill medicare on her behalf.
| Entity Name | Lucid Lane Providers Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1912507021
PECOS PAC ID: 2163839382
Enrollment ID: O20210405001773 |
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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. Mellissa Teresa Bonilla 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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Mellissa Teresa Bonilla, LCSW
1001 Potrero Ave, Ward 93,
San Francisco, CA 94110-3518
Ph: (415) 206-8412 | Mellissa Teresa Bonilla, LCSW
1001 Potrero Ave, Ward 93,
San Francisco, CA 94110-3518
Ph: (415) 206-8412 |
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