Miss Roxana Marisol Servellon, LCSW, CASAC is a medicare enrolled "Social Worker - Clinical" provider in Roslyn, New York. Her current practice location is
15 Bryant Ave, Roslyn, New York. You can reach out to her office (for appointments etc.) via phone at
(516) 547-8610.
Miss Roxana Marisol Servellon is licensed to practice in New York (license number 084222) 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 1477958676.
Healthcare Provider's Profile
Full Name | Miss Roxana Marisol Servellon |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 15 Bryant Ave, Roslyn, New York |
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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: 1477958676
- Provider Enumeration Date: 10/30/2014
- Last Update Date: 06/23/2017
Medicare PECOS Information:
- PECOS PAC ID: 7810333028
- Enrollment ID: I20240311002023
Medical Identifiers
Medical identifiers for Miss Roxana Marisol Servellon such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1477958676 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 2-22379 (New York) | Secondary |
1041C0700X | Social Worker - Clinical | 084222 (New York) | 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 Roxana Marisol Servellon allows following entities to bill medicare on her behalf.
Entity Name | North Shore - Lij Medical Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1053688572 PECOS PAC ID: 3375701568 Enrollment ID: O20120220000262 |
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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 Roxana Marisol Servellon 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 Roxana Marisol Servellon, LCSW, CASAC 15 Bryant Ave, Roslyn, NY 11576-1134 Ph: (516) 547-8610 | Miss Roxana Marisol Servellon, LCSW, CASAC 15 Bryant Ave, Roslyn, NY 11576-1134 Ph: (516) 547-8610 |
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