Michelle Marie Faddoul, LCSW#16997 is a medicare enrolled "Social Worker - Clinical" provider in Tucson, Arizona. She graduated from healthcare school in 2010 and has 14 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Banner Alzheimers Institute and her current practice location is
2626 N. River Road, Tucson, Arizona. You can reach out to her office (for appointments etc.) via phone at
(520) 694-7021.
Michelle Marie Faddoul is licensed to practice in Arizona (license number 16997) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1548541253.
Healthcare Provider's Profile
| Full Name | Michelle Marie Faddoul |
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| Gender | Female |
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| Speciality | Clinical Social Worker |
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| Experience | 14 Years |
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| Location | 2626 N. River Road, Tucson, Arizona |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Michelle Marie Faddoul graduated from medical school in 2010
NPI Data:
- NPI Number: 1548541253
- Provider Enumeration Date: 09/08/2011
- Last Update Date: 05/04/2020
Medicare PECOS Information:
- PECOS PAC ID: 5294065231
- Enrollment ID: I20190918000993
Medical Identifiers
Medical identifiers for Michelle Marie Faddoul such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1548541253 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101Y00000X | Counselor | 28831 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | 16997 (Arizona) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Banner Alzheimers Institute | 8527070101 | 36 |
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. Michelle Marie Faddoul allows following entities to bill medicare on her behalf.
| Entity Name | Banner -- University Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1508809427
PECOS PAC ID: 7719899871
Enrollment ID: O20031105000694 |
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| Entity Name | Banner Alzheimers Institute |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1013966712
PECOS PAC ID: 8527070101
Enrollment ID: O20060623000043 |
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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. Michelle Marie Faddoul 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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Michelle Marie Faddoul, LCSW#16997
2626 N. River Road,
Tucson, AZ 85718
Ph: (520) 694-7021 | Michelle Marie Faddoul, LCSW#16997
2626 N. River Road,
Tucson, AZ 85718
Ph: (520) 694-7021 |
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