Priscilla Sharon-georgia Bake, LMSW is a medicare enrolled "Social Worker - Clinical" provider in Hailey, Idaho. Her current practice location is
1450 Aviation Dr, Hailey, Idaho. You can reach out to her office (for appointments etc.) via phone at
(208) 727-8970.
Priscilla Sharon-georgia Bake is licensed to practice in Idaho (license number 8861956) 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 1770225112.
Healthcare Provider's Profile
| Full Name | Priscilla Sharon-georgia Bake |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 1450 Aviation Dr, Hailey, Idaho |
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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: 1770225112
- Provider Enumeration Date: 04/07/2022
- Last Update Date: 12/03/2024
Medicare PECOS Information:
- PECOS PAC ID: 9739615345
- Enrollment ID: I20241205003745
Medical Identifiers
Medical identifiers for Priscilla Sharon-georgia Bake such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1770225112 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | LMSW-42222 (Idaho) | Secondary |
| 104100000X | Social Worker | LSW-40865 (Idaho) | Secondary |
| 104100000X | Social Worker | LMSW-42222 (Idaho) | Secondary |
| 1041C0700X | Social Worker - Clinical | 8861956 (Idaho) | 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. Priscilla Sharon-georgia Bake allows following entities to bill medicare on her behalf.
| Entity Name | St Lukes Clinic - Wood River Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1972891604
PECOS PAC ID: 3173783818
Enrollment ID: O20120404000474 |
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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. Priscilla Sharon-georgia Bake 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 |
|---|
Priscilla Sharon-georgia Bake, LMSW
190 E Bannock St,
Boise, ID 83712-6241
Ph: () - | Priscilla Sharon-georgia Bake, LMSW
1450 Aviation Dr,
Hailey, ID 83333-8785
Ph: (208) 727-8970 |
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