Mr Dylan Pelham, is a medicare enrolled "Social Worker" provider in Mansfield, Ohio. His current practice location is
741 Scholl Rd, Mansfield, Ohio. You can reach out to his office (for appointments etc.) via phone at
(419) 756-1717.
Mr Dylan Pelham 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 1053775478.
Healthcare Provider's Profile
Full Name | Mr Dylan Pelham |
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Gender | Male |
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Speciality | Social Worker |
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Location | 741 Scholl Rd, Mansfield, 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: 1053775478
- Provider Enumeration Date: 04/12/2016
- Last Update Date: 03/06/2019
Medicare PECOS Information:
- PECOS PAC ID: 3678927654
- Enrollment ID: I20230925002292
Medical Identifiers
Medical identifiers for Mr Dylan Pelham such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1053775478 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 140635 (Ohio) | Secondary |
104100000X | Social Worker | (* (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 Dylan Pelham allows following entities to bill medicare on his behalf.
Entity Name | The Center For Individual And Family Services, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1487669222 PECOS PAC ID: 9133102544 Enrollment ID: O20040608000786 |
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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 Dylan Pelham 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 Dylan Pelham, 741 Scholl Rd, Mansfield, OH 44907-1571 Ph: () - | Mr Dylan Pelham, 741 Scholl Rd, Mansfield, OH 44907 Ph: (419) 756-1717 |
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