Miss Alisa Erickson, is a medicare enrolled "Social Worker - Clinical" provider in Provo, Utah. Her current practice location is
750 N Freedom Blvd, Provo, Utah. You can reach out to her office (for appointments etc.) via phone at
(801) 373-4760.
Miss Alisa Erickson is licensed to practice in * (Not Available) (license number ) 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 1851604276.
Healthcare Provider's Profile
Full Name | Miss Alisa Erickson |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 750 N Freedom Blvd, Provo, Utah |
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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: 1851604276
- Provider Enumeration Date: 07/15/2010
- Last Update Date: 05/17/2022
Medicare PECOS Information:
- PECOS PAC ID: 3274860903
- Enrollment ID: I20190802002912
Medical Identifiers
Medical identifiers for Miss Alisa Erickson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1851604276 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101Y00000X | Counselor | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | (* (Not Available)) | 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. Miss Alisa Erickson allows following entities to bill medicare on her behalf.
Entity Name | Wasatch Behavioral Health Special Service District |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1356357115 PECOS PAC ID: 2567367915 Enrollment ID: O20031129000014 |
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Entity Name | State Of Utah |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1811978620 PECOS PAC ID: 6800797333 Enrollment ID: O20040117000195 |
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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. Miss Alisa Erickson 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 |
Miss Alisa Erickson, 750 N Freedom Blvd, Provo, UT 84601-1677 Ph: (801) 373-4760 | Miss Alisa Erickson, 750 N Freedom Blvd, Provo, UT 84601-1677 Ph: (801) 373-4760 |
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