Mr Jorge Luis Fernandez, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Modesto, California. His current practice location is
1510 Florida Ave, Modesto, California. You can reach out to his office (for appointments etc.) via phone at
(209) 574-1030.
Mr Jorge Luis Fernandez is licensed to practice in California (license number LCS 29234) 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 1538288998.
Healthcare Provider's Profile
| Full Name | Mr Jorge Luis Fernandez |
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| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 1510 Florida Ave, Modesto, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1538288998
- Provider Enumeration Date: 03/28/2007
- Last Update Date: 06/25/2014
Medicare PECOS Information:
- PECOS PAC ID: 0244457745
- Enrollment ID: I20140806002280
Medical Identifiers
Medical identifiers for Mr Jorge Luis Fernandez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1538288998 | NPI | - | NPPES |
| LCS 29234 | Other | CA | LICENSE NUMBER |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YP2500X | Counselor - Professional | ASW19954 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCS 29234 (California) | 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 Jorge Luis Fernandez allows following entities to bill medicare on his behalf.
| Entity Name | Golden Valley Health Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1356445753
PECOS PAC ID: 4183527187
Enrollment ID: O20040128000641 |
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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 Jorge Luis Fernandez 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 Jorge Luis Fernandez, LCSW
737 W Childs Ave,
Merced, CA 95341-6805
Ph: (209) 385-5481 | Mr Jorge Luis Fernandez, LCSW
1510 Florida Ave,
Modesto, CA 95350-4437
Ph: (209) 574-1030 |
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