Kellilynn Bosak, LCSW in Coos Bay, OR - Medicare Social Worker Provider

Kellilynn Bosak, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Coos Bay, Oregon. Her current practice location is 150 S Wall St, Coos Bay, Oregon. You can reach out to her office (for appointments etc.) via phone at (541) 435-7200.

Kellilynn Bosak is licensed to practice in Oregon (license number L8472) 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 1205363421.

Contact Information

	Kellilynn Bosak, LCSW
	150 S Wall St, Coos Bay, OR 97420-3233
	(541) 435-7200
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Kellilynn Bosak
Gender	Female
Speciality	Social Worker - Clinical
Location	150 S Wall St, Coos Bay, Oregon
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1205363421
Provider Enumeration Date: 05/18/2017
Last Update Date: 11/06/2025

Medicare PECOS Information:

PECOS PAC ID: 8729357892
Enrollment ID: I20170705001212

Medical Identifiers

Medical identifiers for Kellilynn Bosak such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1205363421	NPI	-	NPPES
500779268	Medicaid	OR

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	149019376 (Illinois)	Secondary
1041C0700X	Social Worker - Clinical	L8472 (Oregon)	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. Kellilynn Bosak allows following entities to bill medicare on her behalf.

Entity Name	Pcc Community Wellness Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1871516799 PECOS PAC ID: 1557270139 Enrollment ID: O20040206000415

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. Kellilynn Bosak 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
Kellilynn Bosak, LCSW 1900 Woodland Dr, Coos Bay, OR 97420-2099 Ph: (541) 267-5151	Kellilynn Bosak, LCSW 150 S Wall St, Coos Bay, OR 97420-3233 Ph: (541) 435-7200

Reviews and Comments

Social Worker in Coos Bay, OR

Ms. Toni Wyatt-kirkeby, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1620 Thompson Rd, Coos Bay, OR 97420 Phone: 541-269-2986 Fax: 541-266-8640
Mr. Jeffrey G. Friedman, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1610 Thompson Rd, Coos Bay, OR 97420 Phone: 541-269-2986 Fax: 541-269-7987
Laurie C Reis, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 281 Laclair St, Coos Bay, OR 97420 Phone: 541-266-6769
Candace Nicole Wallis, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 125 Central Ave Ste 290, Coos Bay, OR 97420 Phone: 541-267-2113
Ms. Denise E. Stuntzner, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1900 Woodland Dr, Coos Bay, OR 97420 Phone: 541-267-5151
Carol J. Embury, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1610 Thompson Rd, Coos Bay, OR 97420 Phone: 541-269-2986 Fax: 541-269-7987

Kellilynn Bosak, LCSW - Medicare Clinical Social Worker in Coos Bay, OR