Shantara L Bussey-martin, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Miami, Florida. Her current practice location is
3510 Biscayne Blvd, Miami, Florida. You can reach out to her office (for appointments etc.) via phone at
(954) 567-7141.
Shantara L Bussey-martin is licensed to practice in Florida (license number SW19158) 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 1417617028.
Healthcare Provider's Profile
| Full Name | Shantara L Bussey-martin |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 3510 Biscayne Blvd, Miami, 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: 1417617028
- Provider Enumeration Date: 12/22/2021
- Last Update Date: 01/12/2024
Medicare PECOS Information:
- PECOS PAC ID: 1355729930
- Enrollment ID: I20220610000548
Medical Identifiers
Medical identifiers for Shantara L Bussey-martin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1417617028 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | SW19158 (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. Shantara L Bussey-martin 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. Shantara L Bussey-martin 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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Shantara L Bussey-martin, LCSW
5710 Ne Miami Ct,
Miami, FL 33137-2063
Ph: (305) 567-3398 | Shantara L Bussey-martin, LCSW
3510 Biscayne Blvd,
Miami, FL 33137-3840
Ph: (954) 567-7141 |
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