Mary Derbish, LSW in Champaign, IL - Medicare Social Worker Provider

Mary Derbish, LSW is a medicare enrolled "Social Worker - Clinical" provider in Champaign, Illinois. Her current practice location is 505 W University Ave Ste 202-203, Champaign, Illinois. You can reach out to her office (for appointments etc.) via phone at (224) 232-8057.

Mary Derbish is licensed to practice in Illinois (license number 150110706) 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 1003506924.

Contact Information

	Mary Derbish, LSW
	505 W University Ave Ste 202-203, Champaign, IL 61820-3915
	(224) 232-8057
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mary Derbish
Gender	Female
Speciality	Social Worker - Clinical
Location	505 W University Ave Ste 202-203, Champaign, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1003506924
Provider Enumeration Date: 05/12/2023
Last Update Date: 05/12/2023

Medicare PECOS Information:

PECOS PAC ID: 3072031483
Enrollment ID: I20250520000638

Medical Identifiers

Medical identifiers for Mary Derbish such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1003506924	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	150110706 (Illinois)	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. Mary Derbish allows following entities to bill medicare on her behalf.

Entity Name	Child And Family Counseling Of Champaign
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1053814848 PECOS PAC ID: 5092231175 Enrollment ID: O20250501001911

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. Mary Derbish 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
Mary Derbish, LSW 505 W University Ave Ste 202-203, Champaign, IL 61820-3915 Ph: (224) 232-8057	Mary Derbish, LSW 505 W University Ave Ste 202-203, Champaign, IL 61820-3915 Ph: (224) 232-8057

Reviews and Comments

Social Worker in Champaign, IL

Ms. Lisa Diane Barkstall, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1801 Fox Dr, Champaign, IL 61820 Phone: 217-398-8080
Ms. Jennifer Mcnair, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 2503 Jordan Dr, Champaign, IL 61822 Phone: 224-688-8577 Fax: 217-600-7158
Kevin Joseph Elliott, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1807 S Neil St, Champaign, IL 61820 Phone: 815-878-5078
Macey Lyn Jones, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 100 N Chestnut St Ste 225, Champaign, IL 61820 Phone: 217-202-9506 Fax: 217-355-1255
Erica Kay Tonn, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4006 Pinecrest Dr, Champaign, IL 61822 Phone: 217-552-7964
Alethea Grace Deyhle, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 411 E Park St Ste 106, Champaign, IL 61820 Phone: 217-704-7042

Mary Derbish, LSW - Medicare Clinical Social Worker in Champaign, IL