Ms Mimose Montgomery, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Oakland Park, Florida. Her current practice location is
3160 Powerline Rd, Oakland Park, Florida. You can reach out to her office (for appointments etc.) via phone at
(305) 576-1234.
Ms Mimose Montgomery is licensed to practice in Florida (license number SW21589) 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 1922513860.
Healthcare Provider's Profile
| Full Name | Ms Mimose Montgomery |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 3160 Powerline Rd, Oakland Park, Florida |
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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: 1922513860
- Provider Enumeration Date: 12/13/2017
- Last Update Date: 08/19/2024
Medicare PECOS Information:
- PECOS PAC ID: 7911353057
- Enrollment ID: I20231026001761
Medical Identifiers
Medical identifiers for Ms Mimose Montgomery such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1922513860 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | SW21589 (Florida) | Secondary |
| 1041C0700X | Social Worker - Clinical | SW21589 (Florida) | 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. Ms Mimose Montgomery allows following entities to bill medicare on her behalf.
| Entity Name | Care Resource Community Health Centers, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1053311373
PECOS PAC ID: 1658350749
Enrollment ID: O20040714000096 |
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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. Ms Mimose Montgomery 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 |
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Ms Mimose Montgomery, LCSW
8910 Miramar Pkwy Ste 305b,
Miramar, FL 33025-4100
Ph: (305) 713-3261 | Ms Mimose Montgomery, LCSW
3160 Powerline Rd,
Oakland Park, FL 33309-5911
Ph: (305) 576-1234 |
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