Shelley Beth Kingsbury, LCSW in Mystic, CT - Medicare Social Worker Provider

Shelley Beth Kingsbury, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Mystic, Connecticut. Her current practice location is 1101 Noank Ledyard Rd # 12, Mystic, Connecticut. You can reach out to her office (for appointments etc.) via phone at (860) 861-8393.

Shelley Beth Kingsbury is licensed to practice in Connecticut (license number 010666) 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 1104462654.

Contact Information

	Shelley Beth Kingsbury, LCSW
	1101 Noank Ledyard Rd # 12, Mystic, CT 06355-1361
	(860) 861-8393
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Shelley Beth Kingsbury
Gender	Female
Speciality	Social Worker - Clinical
Location	1101 Noank Ledyard Rd # 12, Mystic, Connecticut
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1104462654
Provider Enumeration Date: 11/20/2019
Last Update Date: 08/26/2021

Medicare PECOS Information:

PECOS PAC ID: 3779993415
Enrollment ID: I20201108000000

Medical Identifiers

Medical identifiers for Shelley Beth Kingsbury such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1104462654	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	010666 (Connecticut)	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. Shelley Beth Kingsbury allows following entities to bill medicare on her behalf.

Entity Name	Windham Community Memorial Hospital, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1023191467 PECOS PAC ID: 2961309059 Enrollment ID: O20031217000231

Entity Name	The William W Backus Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1467517235 PECOS PAC ID: 0749170645 Enrollment ID: O20040316000739

Entity Name	State Of Connecticut
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1902831548 PECOS PAC ID: 8022915677 Enrollment ID: O20040319000291

Entity Name	State Of Connecticut
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1427074426 PECOS PAC ID: 8022915677 Enrollment ID: O20040319000365

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. Shelley Beth Kingsbury 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
Shelley Beth Kingsbury, LCSW 22a Autumn View Dr, Lisbon, CT 06351-2901 Ph: (860) 861-8393	Shelley Beth Kingsbury, LCSW 1101 Noank Ledyard Rd # 12, Mystic, CT 06355-1361 Ph: (860) 861-8393

Reviews and Comments

Social Worker in Mystic, CT

Mrs. Shanna Tari Reels, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 282 Noank Ledyard Rd, Mystic, CT 06355 Phone: 860-245-5587
Anne Rivers, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 12 Roosevelt Ave, Suite 203, Mystic, CT 06355 Phone: 860-536-4383 Fax: 860-536-2873
Daniel Stubbs Brown, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 47 Water St, Mystic, CT 06355 Phone: 860-690-7048
Ms. Shaina Dawn Wilkinson, MSW, LMSW,LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 12 Roosevelt Ave Ste Office2, Mystic, CT 06355 Phone: 860-245-9764
Ms. Cathy Ilene Adair, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 190 N Stonington Rd, Mystic, CT 06355 Phone: 860-536-8622
Ms. Diana D Hutchinson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4 Clipper Dr, Mystic, CT 06355 Phone: 860-608-1720

Shelley Beth Kingsbury, LCSW - Medicare Clinical Social Worker in Mystic, CT