Mrs Marisa Leigh Moss, is a medicare enrolled "Social Worker - Clinical" provider in Provo, Utah. Her current practice location is
750 N Freedom Blvd, Provo, Utah. You can reach out to her office (for appointments etc.) via phone at
(801) 373-4760.
Mrs Marisa Leigh Moss is licensed to practice in Utah (license number 11295956-3501) 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 1497234132.
Healthcare Provider's Profile
Full Name | Mrs Marisa Leigh Moss |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 750 N Freedom Blvd, Provo, Utah |
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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: 1497234132
- Provider Enumeration Date: 08/13/2018
- Last Update Date: 04/27/2023
Medicare PECOS Information:
- PECOS PAC ID: 7113459355
- Enrollment ID: I20241014001727
Medical Identifiers
Medical identifiers for Mrs Marisa Leigh Moss such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1497234132 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101Y00000X | Counselor | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | 11295956-3501 (Utah) | 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. Mrs Marisa Leigh Moss allows following entities to bill medicare on her behalf.
Entity Name | Wasatch Behavioral Health Special Service District |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1356357115 PECOS PAC ID: 2567367915 Enrollment ID: O20031129000014 |
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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. Mrs Marisa Leigh Moss 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 |
Mrs Marisa Leigh Moss, 4423 N Country Wood Dr, Lehi, UT 84043-4769 Ph: (385) 528-5962 | Mrs Marisa Leigh Moss, 750 N Freedom Blvd, Provo, UT 84601 Ph: (801) 373-4760 |
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