Kimberly H Fortin, LCSW-R is a medicare enrolled "Social Worker - Clinical" provider in Weedsport, New York. Her current practice location is
2693 East Brutus Street, Weedsport, New York. You can reach out to her office (for appointments etc.) via phone at
(315) 834-2014.
Kimberly H Fortin is licensed to practice in New York (license number 076593) 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 1215046123.
Healthcare Provider's Profile
| Full Name | Kimberly H Fortin |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 2693 East Brutus Street, Weedsport, New York |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1215046123
- Provider Enumeration Date: 08/30/2006
- Last Update Date: 12/03/2013
Medicare PECOS Information:
- PECOS PAC ID: 5496892259
- Enrollment ID: I20091027000670
Medical Identifiers
Medical identifiers for Kimberly H Fortin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1215046123 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 1041C0700X | Social Worker - Clinical | 076593 (New York) | Primary |
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. Kimberly H Fortin 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 |
Kimberly H Fortin, LCSW-R P.o. Box 1241, Weedsport, NY 13166 Ph: (315) 834-2014 | Kimberly H Fortin, LCSW-R 2693 East Brutus Street, Weedsport, NY 13166 Ph: (315) 834-2014 |
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