Mr Douglas Mark Shine, LCSW in Saint Johns, FL - Medicare Clinical Social Worker Provider

Mr Douglas Mark Shine, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Saint Johns, Florida. He graduated from medical school in 1972 and has 54 years of diverse experience with area of expertise as Clinical Social Worker. He is a member of the group practice Optum Behavioral Care Of North Carolina Pc and his current practice location is 1705 Duck Water Ct, Saint Johns, Florida. You can reach out to his office (for appointments etc.) via phone at (904) 287-3122.

Mr Douglas Mark Shine is licensed to practice in Florida (license number SW0001447) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1992821201.

Contact Information

	Mr Douglas Mark Shine, LCSW
	1705 Duck Water Ct, Saint Johns, FL 32259-5247
	(904) 287-3122
	(904) 287-3122

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Douglas Mark Shine
Gender	Male
Speciality	Clinical Social Worker
Experience	54 Years
Location	1705 Duck Water Ct, Saint Johns, Florida
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mr Douglas Mark Shine graduated from medical school in 1972

NPI Data:

NPI Number: 1992821201
Provider Enumeration Date: 03/21/2007
Last Update Date: 09/10/2012

Medicare PECOS Information:

PECOS PAC ID: 0244513323
Enrollment ID: I20170215002743

Medical Identifiers

Medical identifiers for Mr Douglas Mark Shine such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1992821201	NPI	-	NPPES
761636800	Medicaid	FL
SW0001447	Other	FL	CLINICAL SOCIAL WORKER FL

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	SW0001447 (Florida)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Optum Behavioral Care Of North Carolina Pc	5092120030	161

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. Mr Douglas Mark Shine allows following entities to bill medicare on his behalf.

Entity Name	Refresh Canopy Cove, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1730661752 PECOS PAC ID: 3779822119 Enrollment ID: O20190304000354

Entity Name	Optum Behavioral Care Of North Carolina Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1033984448 PECOS PAC ID: 5092120030 Enrollment ID: O20240401000110

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. Mr Douglas Mark Shine 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
Mr Douglas Mark Shine, LCSW 1705 Duck Water Ct, Jacksonville, FL 32259-5247 Ph: (904) 287-3122	Mr Douglas Mark Shine, LCSW 1705 Duck Water Ct, Saint Johns, FL 32259-5247 Ph: (904) 287-3122

Reviews and Comments

Social Worker in Saint Johns, FL

Debbie Carroll-rebhan, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1020 W Dorchester Dr, Saint Johns, FL 32259 Phone: 904-614-1356
Mrs. Kelly Connolly Wayland, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 190 Clifton Bay Loop, Saint Johns, FL 32259 Phone: 610-952-6801
Anna Tonsing, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 777 S Lilac Loop, Saint Johns, FL 32259 Phone: 904-319-5583
Jennifer Stephenson, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4428 N Pennycress Pl, Saint Johns, FL 32259 Phone: 401-744-3893
Kelsey L. Bloom, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 30 Ardisia Ln, Saint Johns, FL 32259 Phone: 904-376-3800 Fax: 904-390-7458
Alicia Kiernan, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 760 Roberts Rd, Saint Johns, FL 32259 Phone: 904-386-6465

Mr Douglas Mark Shine, LCSW - Medicare Clinical Social Worker in Saint Johns, FL