Mr Blaine G Burks, LMSW,CAAC is a medicare enrolled "Social Worker - Clinical" provider in Lima, Ohio. His current practice location is
311 E Market St Ste 3, Lima, Ohio. You can reach out to his office (for appointments etc.) via phone at
(419) 222-4474.
Mr Blaine G Burks is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1174632145.
Healthcare Provider's Profile
Full Name | Mr Blaine G Burks |
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Gender | Male |
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Speciality | Social Worker - Clinical |
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Location | 311 E Market St Ste 3, Lima, Ohio |
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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: 1174632145
- Provider Enumeration Date: 08/30/2006
- Last Update Date: 06/15/2023
Medicare PECOS Information:
- PECOS PAC ID: 1557463064
- Enrollment ID: I20130417000143
Medical Identifiers
Medical identifiers for Mr Blaine G Burks such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1174632145 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 6801064874 (Michigan) | 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. Mr Blaine G Burks allows following entities to bill medicare on his behalf.
Entity Name | Neighborhood Service Organization |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1891825808 PECOS PAC ID: 7113907387 Enrollment ID: O20040720001455 |
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Entity Name | Royal Universal Adult Care |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1275135345 PECOS PAC ID: 8921411521 Enrollment ID: O20201228001269 |
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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. Mr Blaine G Burks 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 |
Mr Blaine G Burks, LMSW,CAAC 19323 Ardmore St, Detroit, MI 48235-1704 Ph: (313) 585-2242 | Mr Blaine G Burks, LMSW,CAAC 311 E Market St Ste 3, Lima, OH 45801-4535 Ph: (419) 222-4474 |
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