David Jackson, LICSW in Pine City, MN - Medicare Social Worker Provider

David Jackson, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Pine City, Minnesota. His current practice location is 220 Railroad St Se, Pine City, Minnesota. You can reach out to his office (for appointments etc.) via phone at (320) 629-7600.

David Jackson is licensed to practice in Minnesota (license number 21551) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1548972425.

Contact Information

	David Jackson, LICSW
	220 Railroad St Se, Pine City, MN 55063-1540
	(320) 629-7600
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	David Jackson
Gender	Male
Speciality	Social Worker - Clinical
Location	220 Railroad St Se, Pine City, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1548972425
Provider Enumeration Date: 12/22/2022
Last Update Date: 12/22/2022

Medicare PECOS Information:

PECOS PAC ID: 4385001361
Enrollment ID: I20230606003501

Medical Identifiers

Medical identifiers for David Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1548972425	NPI	-	NPPES
21551	Medicaid	MN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	21551 (Minnesota)	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. David Jackson allows following entities to bill medicare on his behalf.

Entity Name	Therapeutic Services Agency Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1497741607 PECOS PAC ID: 4981877891 Enrollment ID: O20111109000030

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. David Jackson 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
David Jackson, LICSW 220 Railroad St Se, Pine City, MN 55063-1540 Ph: (320) 629-7600	David Jackson, LICSW 220 Railroad St Se, Pine City, MN 55063-1540 Ph: (320) 629-7600

Reviews and Comments

Social Worker in Pine City, MN

Mrs. Kelly Ann Buchta, MSW, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 220 Railroad St Se, Pine City, MN 55063 Phone: 320-629-7600
Angela Marie Kemen, MSW, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 705 Hillside Ave Sw, Pine City, MN 55063 Phone: 320-629-7600 Fax: 651-925-0071
Bethany Almos, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 220 Railroad St Se, Pine City, MN 55063 Phone: 320-629-7600
Karlie Gams, MSW, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 220 Railroad St Se, Pine City, MN 55063 Phone: 320-629-7600
Danielle Aubuchon, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 220 Railroad St Se, Pine City, MN 55063 Phone: 320-629-7600
Mitchell Lee Demers, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 220 Railroad St Se, Pine City, MN 55063 Phone: 320-629-7600 Fax: 651-925-0071
Brenna Lyn Macdonald, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 220 Railroad St Se, Pine City, MN 55063 Phone: 320-629-7600 Fax: 651-925-0071

David Jackson, LICSW - Medicare Clinical Social Worker in Pine City, MN