Andrea Wilson, LISW is a medicare enrolled "Social Worker - Clinical" provider in Columbus, Ohio. Her current practice location is
2780 Airport Dr Ste 100, Columbus, Ohio. You can reach out to her office (for appointments etc.) via phone at
(614) 859-1906.
Andrea Wilson is licensed to practice in Ohio (license number I.1302802-SUPV) 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 1154461960.
Healthcare Provider's Profile
| Full Name | Andrea Wilson |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 2780 Airport Dr Ste 100, Columbus, Ohio |
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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: 1154461960
- Provider Enumeration Date: 02/08/2007
- Last Update Date: 03/15/2022
Medicare PECOS Information:
- PECOS PAC ID: 4486049681
- Enrollment ID: I20220325001604
Medical Identifiers
Medical identifiers for Andrea Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1154461960 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 091086 (Ohio) | Secondary |
| 1041C0700X | Social Worker - Clinical | S1100574 (Ohio) | Secondary |
| 1041C0700X | Social Worker - Clinical | I.1302802-SUPV (Ohio) | Primary |
| 171M00000X | Case Manager/care Coordinator | (NU) | Secondary |
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. Andrea Wilson allows following entities to bill medicare on her behalf.
| Entity Name | Third Street Community Clinic, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1720407554
PECOS PAC ID: 2365423977
Enrollment ID: O20141020001750 |
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| Entity Name | Third Street Community Clinic, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1306499314
PECOS PAC ID: 2365423977
Enrollment ID: O20200420003356 |
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| Entity Name | Third Street Community Clinic, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1669158838
PECOS PAC ID: 2365423977
Enrollment ID: O20230807001755 |
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| Entity Name | Third Street Community Clinic, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1861170565
PECOS PAC ID: 2365423977
Enrollment ID: O20231215002895 |
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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. Andrea Wilson 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 |
|---|
Andrea Wilson, LISW
2780 Airport Dr Ste 100,
Columbus, OH 43219-2289
Ph: (614) 859-1906 | Andrea Wilson, LISW
2780 Airport Dr Ste 100,
Columbus, OH 43219-2289
Ph: (614) 859-1906 |
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