Mr Larry Wayne Breedlove, is a medicare enrolled "Social Worker - Clinical" provider in Hollidaysburg, Pennsylvania. His current practice location is
1906 N Juniata St, Hollidaysburg, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at
(814) 695-2984.
Mr Larry Wayne Breedlove is licensed to practice in Pennsylvania (license number CW023022) 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 1326179474.
Healthcare Provider's Profile
Full Name | Mr Larry Wayne Breedlove |
---|
Gender | Male |
---|
Speciality | Social Worker - Clinical |
---|
Location | 1906 N Juniata St, Hollidaysburg, Pennsylvania |
---|
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1326179474
- Provider Enumeration Date: 03/08/2007
- Last Update Date: 07/28/2023
Medicare PECOS Information:
- PECOS PAC ID: 3577931567
- Enrollment ID: I20221123000034
Medical Identifiers
Medical identifiers for Mr Larry Wayne Breedlove such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1326179474 | NPI | - | NPPES |
SYC7165 | Other | CA | STAFF CODE |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101Y00000X | Counselor | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | CW023022 (Pennsylvania) | 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 Larry Wayne Breedlove allows following entities to bill medicare on his behalf.
Entity Name | Upmc Behavioral Health Of The Alleghenies |
---|
Entity Type | Part B Supplier - Clinic/group Practice |
---|
Entity Identifiers | NPI Number: 1063587103 PECOS PAC ID: 6103733068 Enrollment ID: O20110110000792 |
---|
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 Larry Wayne Breedlove 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 Larry Wayne Breedlove, 1906 N Juniata St, Hollidaysburg, PA 16648-1908 Ph: (814) 695-2984 | Mr Larry Wayne Breedlove, 1906 N Juniata St, Hollidaysburg, PA 16648-1908 Ph: (814) 695-2984 |
Reviews and Comments