Nicole Wright, is a medicare enrolled "Social Worker - Clinical" provider in Gardena, California. Her current practice location is
879 W 190th St Ste 300, Gardena, California. You can reach out to her office (for appointments etc.) via phone at
(310) 850-0115.
Nicole Wright is licensed to practice in California (license number 121100) 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 1811123698.
Healthcare Provider's Profile
| Full Name | Nicole Wright |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 879 W 190th St Ste 300, Gardena, 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: 1811123698
- Provider Enumeration Date: 06/07/2009
- Last Update Date: 07/10/2024
Medicare PECOS Information:
- PECOS PAC ID: 6800320110
- Enrollment ID: I20241108002957
Medical Identifiers
Medical identifiers for Nicole Wright such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1811123698 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | 112706 (California) | Secondary |
| 101YM0800X | Counselor - Mental Health | ASW75318 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | 112706 (California) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 121100 (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. Nicole Wright allows following entities to bill medicare on her behalf.
| Entity Name | Special Service For Groups |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1952442949
PECOS PAC ID: 2769396886
Enrollment ID: O20031113000561 |
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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. Nicole Wright 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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Nicole Wright,
879 W 190th St Ste 300,
Gardena, CA 90248-4223
Ph: (310) 850-0115 | Nicole Wright,
879 W 190th St Ste 300,
Gardena, CA 90248-4223
Ph: (310) 850-0115 |
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