Ambyr Rose Stores, MSW, LCSW, QMHP is a medicare enrolled "Social Worker - Clinical" provider in Eugene, Oregon. Her current practice location is
1599 Oak St, Eugene, Oregon. You can reach out to her office (for appointments etc.) via phone at
(541) 255-1411.
Ambyr Rose Stores is licensed to practice in Oregon (license number L10359) 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 1730545211.
Healthcare Provider's Profile
| Full Name | Ambyr Rose Stores |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 1599 Oak St, Eugene, Oregon |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1730545211
- Provider Enumeration Date: 01/13/2016
- Last Update Date: 01/10/2022
Medicare PECOS Information:
- PECOS PAC ID: 4486067584
- Enrollment ID: I20210111000750
Medical Identifiers
Medical identifiers for Ambyr Rose Stores such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1730545211 | NPI | - | NPPES |
| 1730545211 | Medicaid | OR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | A4910 (Oregon) | Secondary |
| 1041C0700X | Social Worker - Clinical | L10359 (Oregon) | 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. Ambyr Rose Stores allows following entities to bill medicare on her behalf.
| Entity Name | Beautiful Minds Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1336809847
PECOS PAC ID: 8729470752
Enrollment ID: O20220124002267 |
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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. Ambyr Rose Stores 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 |
|---|
Ambyr Rose Stores, MSW, LCSW, QMHP
1430 Willamette St # 140,
Eugene, OR 97401-4049
Ph: (541) 255-1411 | Ambyr Rose Stores, MSW, LCSW, QMHP
1599 Oak St,
Eugene, OR 97401-4008
Ph: (541) 255-1411 |
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