Tracy M Bodford, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Jacksonville, Florida. Her current practice location is
4500 San Pablo Rd S, Jacksonville, Florida. You can reach out to her office (for appointments etc.) via phone at
(904) 953-2000.
Tracy M Bodford is licensed to practice in Florida (license number SW15499) 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 1679736011.
Healthcare Provider's Profile
| Full Name | Tracy M Bodford |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 4500 San Pablo Rd S, Jacksonville, 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: 1679736011
- Provider Enumeration Date: 07/07/2008
- Last Update Date: 10/12/2020
Medicare PECOS Information:
- PECOS PAC ID: 8729148838
- Enrollment ID: I20191205001784
Medical Identifiers
Medical identifiers for Tracy M Bodford such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1679736011 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | C006079 (North Carolina) | Secondary |
| 1041C0700X | Social Worker - Clinical | SW15499 (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. Tracy M Bodford allows following entities to bill medicare on her behalf.
| Entity Name | Mayo Clinic Jacksonville |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1790772317
PECOS PAC ID: 5698689297
Enrollment ID: O20031118000388 |
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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. Tracy M Bodford 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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Tracy M Bodford, LCSW
4500 San Pablo Rd S,
Jacksonville, FL 32224-1865
Ph: (904) 953-2000 | Tracy M Bodford, LCSW
4500 San Pablo Rd S,
Jacksonville, FL 32224
Ph: (904) 953-2000 |
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