Jessie A Bacon, LCSW in Fort Hall, ID - Medicare Social Worker Provider

Jessie A Bacon, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Fort Hall, Idaho. Her current practice location is Mission Road Blding 248, Fort Hall Indian Agency, Fort Hall, Idaho. You can reach out to her office (for appointments etc.) via phone at (208) 237-5631.

Jessie A Bacon is licensed to practice in Idaho (license number LCSW-32218) 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 1750507604.

Contact Information

	Jessie A Bacon, LCSW
	Mission Road Blding 248, Fort Hall Indian Agency, Fort Hall, ID 83203
	(208) 237-5631
	(208) 237-5796

Map and Direction

Healthcare Provider's Profile

Full Name	Jessie A Bacon
Gender	Female
Speciality	Social Worker - Clinical
Location	Mission Road Blding 248, Fort Hall, Idaho
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1750507604
Provider Enumeration Date: 04/18/2007
Last Update Date: 03/18/2024

Medicare PECOS Information:

PECOS PAC ID: 5193854727
Enrollment ID: I20100520000176

Medical Identifiers

Medical identifiers for Jessie A Bacon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1750507604	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	LCSW-32218 (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. Jessie A Bacon allows following entities to bill medicare on her behalf.

Entity Name	Shoshone Bannock Tribes Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1801949763 PECOS PAC ID: 5496804429 Enrollment ID: O20100330001318

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. Jessie A Bacon 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
Jessie A Bacon, LCSW 1068 E Reservation Rich Ln, Blackfoot, ID 83221-7052 Ph: (208) 681-6980	Jessie A Bacon, LCSW Mission Road Blding 248, Fort Hall Indian Agency, Fort Hall, ID 83203 Ph: (208) 237-5631

Reviews and Comments

Social Worker in Fort Hall, ID

Mr. Thayne Andersen, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 717 Mission Road, Fort Hall, ID 83203 Phone: 208-237-5631 Fax: 208-237-5796
Daniel Jerome Hall, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 717 Mission Road, Fort Hall, ID 83203 Phone: 208-237-5631 Fax: 208-237-5796
Willow Rose Abrahamson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 85 A. West Agency Road, Fort Hall, ID 83203 Phone: 208-339-9559
Ms. Shari L. Newsome, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: Mission Road Building 248, Fort Hall Indian Agency, Fort Hall, ID 83203 Phone: 208-237-5631 Fax: 208-237-5796
Ms. Kristy Lee Broncho, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: Mission Road Blding 248, Fort Hall Indian Agency, Fort Hall, ID 83203 Phone: 208-237-5631 Fax: 208-237-5796
Matthew J Wadsworth, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 717 Mission Road, Fort Hall, ID 83203 Phone: 208-237-5631 Fax: 208-237-5796

Jessie A Bacon, LCSW - Medicare Clinical Social Worker in Fort Hall, ID