Tina Lilliedoll, is a medicare enrolled "Social Worker - Clinical" provider in Davis, California. Her current practice location is
600 A St, Davis, California. You can reach out to her office (for appointments etc.) via phone at
(530) 668-2400.
Tina Lilliedoll is licensed to practice in California (license number 97349) 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 1518177443.
Healthcare Provider's Profile
| Full Name | Tina Lilliedoll |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 600 A St, Davis, 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: 1518177443
- Provider Enumeration Date: 05/22/2007
- Last Update Date: 12/03/2021
Medicare PECOS Information:
- PECOS PAC ID: 6305298522
- Enrollment ID: I20240123003319
Medical Identifiers
Medical identifiers for Tina Lilliedoll such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1518177443 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | ASW78894 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | 97349 (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. Tina Lilliedoll allows following entities to bill medicare on her behalf.
| Entity Name | Communicare Health Centers |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1558366823
PECOS PAC ID: 0345299186
Enrollment ID: O20161129002365 |
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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. Tina Lilliedoll 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 |
|---|
Tina Lilliedoll,
Po Box 1260,
Davis, CA 95617-1260
Ph: (530) 753-3498 | Tina Lilliedoll,
600 A St,
Davis, CA 95616-3649
Ph: (530) 668-2400 |
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