Misty M Bonham, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Canby, Oregon. Her current practice location is
358 Nw 1st Ave Ste 3, Canby, Oregon. You can reach out to her office (for appointments etc.) via phone at
(503) 427-8255.
Misty M Bonham is licensed to practice in Oregon (license number L11217) 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 1467010397.
Healthcare Provider's Profile
Full Name | Misty M Bonham |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 358 Nw 1st Ave Ste 3, Canby, Oregon |
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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: 1467010397
- Provider Enumeration Date: 06/05/2019
- Last Update Date: 10/16/2023
Medicare PECOS Information:
- PECOS PAC ID: 4981047578
- Enrollment ID: I20240212000599
Medical Identifiers
Medical identifiers for Misty M Bonham such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1467010397 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | L11217 (Oregon) | 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. Misty M Bonham allows following entities to bill medicare on her behalf.
Entity Name | Misty Bonham Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1417729872 PECOS PAC ID: 3072956663 Enrollment ID: O20240212000562 |
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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. Misty M Bonham 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 |
Misty M Bonham, LCSW Po Box 755, Canby, OR 97013-0755 Ph: (503) 427-8255 | Misty M Bonham, LCSW 358 Nw 1st Ave Ste 3, Canby, OR 97013-3533 Ph: (503) 427-8255 |
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