Sandra Susan Blazek, MSW in Effingham, IL - Medicare Social Worker Provider

Sandra Susan Blazek, MSW is a medicare enrolled "Social Worker - Clinical" provider in Effingham, Illinois. Her current practice location is 900 W Temple Ave Ste 208, Effingham, Illinois. You can reach out to her office (for appointments etc.) via phone at (217) 342-0211.

Sandra Susan Blazek is licensed to practice in North Carolina (license number P011740) 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 1942721295.

Contact Information

	Sandra Susan Blazek, MSW
	900 W Temple Ave Ste 208, Effingham, IL 62401-2187
	(217) 342-0211
	(217) 342-0232

Map and Direction

Healthcare Provider's Profile

Full Name	Sandra Susan Blazek
Gender	Female
Speciality	Social Worker - Clinical
Location	900 W Temple Ave Ste 208, Effingham, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1942721295
Provider Enumeration Date: 06/27/2017
Last Update Date: 03/28/2024

Medicare PECOS Information:

PECOS PAC ID: 8527390392
Enrollment ID: I20191028002062

Medical Identifiers

Medical identifiers for Sandra Susan Blazek such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1942721295	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	P011740 (North Carolina)	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. Sandra Susan Blazek allows following entities to bill medicare on her behalf.

Entity Name	Carolina Outreach, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1083723266 PECOS PAC ID: 0446449748 Enrollment ID: O20110118000335

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. Sandra Susan Blazek 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
Sandra Susan Blazek, MSW 900 W Temple Ave Ste 208, Effingham, IL 62401-2187 Ph: (217) 342-0211	Sandra Susan Blazek, MSW 900 W Temple Ave Ste 208, Effingham, IL 62401-2187 Ph: (217) 342-0211

Reviews and Comments

Social Worker in Effingham, IL

Mr. Thomas Wayne Moll, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 300 N Maple St, Effingham, IL 62401 Phone: 217-342-4151
Jamie Lee Mcclain, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1200 N 4th St, Effingham, IL 62401 Phone: 217-347-7179
Mr. Justin E Hampton, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 900 W Temple Ave Ste 208, Effingham, IL 62401 Phone: 217-342-0211 Fax: 217-342-0232
Beth Stundon, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 405 S 3rd St, Effingham, IL 62401 Phone: 217-994-4898
Emily Anne Schall, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 405 S 3rd St, Effingham, IL 62401 Phone: 217-343-8242 Fax: 217-994-9206
Afthan Reents, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1200 N 4th St, Effingham, IL 62401 Phone: 217-347-7179
Mrs. Tamara Nanette Jones, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1011 Ford Ave, Effingham, IL 62401 Phone: 217-347-7600 Fax: 217-342-9733

Sandra Susan Blazek, MSW - Medicare Clinical Social Worker in Effingham, IL