Mrs Mary Beth Russo Blackwell, LCSW - Medicare Clinical Social Worker in Ormond Beach, FL

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Mrs Mary Beth Russo Blackwell, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Ormond Beach, Florida. Her current practice location is 220 Arlington Way, Ormond Beach, Florida. You can reach out to her office (for appointments etc.) via phone at (386) 882-7251.

Mrs Mary Beth Russo Blackwell is licensed to practice in Florida (license number SW18791) 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 1063731263.

Contact Information

Mrs Mary Beth Russo Blackwell, LCSW
220 Arlington Way,
Ormond Beach, FL 32176-8164
(386) 882-7251
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameMrs Mary Beth Russo Blackwell
GenderFemale
SpecialitySocial Worker - Clinical
Location220 Arlington Way, Ormond Beach, Florida
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1063731263
  • Provider Enumeration Date: 05/27/2010
  • Last Update Date: 03/03/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 8224359203
  • Enrollment ID: I20221115000356

Medical Identifiers

Medical identifiers for Mrs Mary Beth Russo Blackwell such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063731263NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical SW18791 (Florida)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. Mrs Mary Beth Russo Blackwell allows following entities to bill medicare on her behalf.
Entity NameRefresh Canopy Cove, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1730661752
PECOS PAC ID: 3779822119
Enrollment ID: O20190304000354
Entity NameOptum Behavioral Care Of North Carolina Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1033984448
PECOS PAC ID: 5092120030
Enrollment ID: O20240401000110
Entity NameMary Beth R Blackwell Lcsw Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1578395950
PECOS PAC ID: 3971043308
Enrollment ID: O20240911003395

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. Mrs Mary Beth Russo Blackwell 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 AddressPractice Location Address
Mrs Mary Beth Russo Blackwell, LCSW
220 Arlington Way,
Ormond Beach, FL 32176-8164

Ph: (386) 882-7251		Mrs Mary Beth Russo Blackwell, LCSW
220 Arlington Way,
Ormond Beach, FL 32176-8164

Ph: (386) 882-7251

Reviews and Comments


Social Worker in Ormond Beach, FL

Sara Mousikos,
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Practice Location: 454 S Yonge St, Ormond Beach, FL 32174
Phone: 772-453-8119    
Ms. Tanya Allen, LCSW
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Phone: 239-690-6906    
Gwen H Kotler, MSW,LCSW
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Mrs. Brittany Sweeting, SW
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Practice Location: 98 Bella Vita Way, Ormond Beach, FL 32174
Phone: 386-383-7238    
Kyle Joseph Gilrain, LICSW
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Practice Location: 570 Memorial Cir Ste 310, Ormond Beach, FL 32174
Phone: 386-290-2993    
Michael Chase,
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Practice Location: 845 John Anderson Dr, Ormond Beach, FL 32176
Phone: 386-299-9919    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.