Koi Derrick Cook, in Moab, UT - Medicare Social Worker Provider

Koi Derrick Cook, is a medicare enrolled "Social Worker - Clinical" provider in Moab, Utah. His current practice location is 198 E Center St, Moab, Utah. You can reach out to his office (for appointments etc.) via phone at (435) 259-6131.

Koi Derrick Cook is licensed to practice in Utah (license number 12693112-3501) 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 1568119048.

Contact Information

	Koi Derrick Cook,
	198 E Center St, Moab, UT 84532-2430
	(435) 259-6131
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Koi Derrick Cook
Gender	Male
Speciality	Social Worker - Clinical
Location	198 E Center St, Moab, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1568119048
Provider Enumeration Date: 03/04/2022
Last Update Date: 09/25/2025

Medicare PECOS Information:

PECOS PAC ID: 9931629375
Enrollment ID: I20250228000148

Medical Identifiers

Medical identifiers for Koi Derrick Cook such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1568119048	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	12693112-3501 (Utah)	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. Koi Derrick Cook allows following entities to bill medicare on his behalf.

Entity Name	Four Corners Community Behavioral Health Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1487715330 PECOS PAC ID: 2769377415 Enrollment ID: O20040220000304

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. Koi Derrick Cook 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
Koi Derrick Cook, Po Box 867, Price, UT 84501-0867 Ph: (435) 637-7200	Koi Derrick Cook, 198 E Center St, Moab, UT 84532-2430 Ph: (435) 259-6131

Reviews and Comments

Social Worker in Moab, UT

Mr. Carl Jason Sorenson, MSW, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 81 N 300 E, Moab, UT 84532 Phone: 435-612-0788
Delrea B Lilligridge, SSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 198 East Center Street, Moab, UT 84532 Phone: 435-259-6131 Fax: 435-259-5369
Kaylie Corrigan, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2476 Spanish Valley Dr, Moab, UT 84532 Phone: 970-819-4791
Jacquelin Hahn, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 375 S Main St # 322, Moab, UT 84532 Phone: 505-633-5470
Terry Galen, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 198 East Center Street, Moab, UT 84532 Phone: 435-259-6131 Fax: 435-259-5369
Ms. Eva Lou Beatty, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 115 W 200 S # 7, Moab, UT 84532 Phone: 435-260-2324
Ronald Dale Day, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 198 E Center St, Moab, UT 84532 Phone: 435-259-6131

Koi Derrick Cook, - Medicare Clinical Social Worker in Moab, UT