Nicolle Roth, LCSW in Manor, TX - Medicare Social Worker Provider

Nicolle Roth, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Manor, Texas. Her current practice location is 13620 James Buchanan St, Manor, Texas. You can reach out to her office (for appointments etc.) via phone at (406) 471-2474.

Nicolle Roth is licensed to practice in Texas (license number 106181) 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 1326845744.

Contact Information

	Nicolle Roth, LCSW
	13620 James Buchanan St, Manor, TX 78653-4087
	(406) 471-2474
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Nicolle Roth
Gender	Female
Speciality	Social Worker - Clinical
Location	13620 James Buchanan St, Manor, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1326845744
Provider Enumeration Date: 02/25/2025
Last Update Date: 02/25/2025

Medicare PECOS Information:

PECOS PAC ID: 4789107707
Enrollment ID: I20250401000434

Medical Identifiers

Medical identifiers for Nicolle Roth such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1326845744	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	CSW.09931317 (Colorado)	Secondary
1041C0700X	Social Worker - Clinical	106181 (Texas)	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. Nicolle Roth allows following entities to bill medicare on her behalf.

Entity Name	Grow Healthcare Group Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220525002138

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. Nicolle Roth 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
Nicolle Roth, LCSW 13620 James Buchanan St, Manor, TX 78653-4087 Ph: () -	Nicolle Roth, LCSW 13620 James Buchanan St, Manor, TX 78653-4087 Ph: (406) 471-2474

Reviews and Comments

Social Worker in Manor, TX

Keshayka Shantell Williams, LCSW-S Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 13917 Virtue St, Manor, TX 78653 Phone: 512-850-5457
Jody Gardner, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 9909 Becoming St, Manor, TX 78653 Phone: 239-850-2050
Elizabeth Ann Dyson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 12809 Dwight Eisenhower St, Manor, TX 78653 Phone: 540-226-3932

Nicolle Roth, LCSW - Medicare Clinical Social Worker in Manor, TX