Banaly Blaise, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Orlando, Florida. Her current practice location is
8430 Rose Groves Rd, Orlando, Florida. You can reach out to her office (for appointments etc.) via phone at
(407) 859-2882.
Banaly Blaise is licensed to practice in * (Not Available) (license number ) 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 1225578495.
Healthcare Provider's Profile
Full Name | Banaly Blaise |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 8430 Rose Groves Rd, Orlando, Florida |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1225578495
- Provider Enumeration Date: 03/07/2017
- Last Update Date: 04/06/2021
Medicare PECOS Information:
- PECOS PAC ID: 7012320849
- Enrollment ID: I20210115000298
Medical Identifiers
Medical identifiers for Banaly Blaise such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1225578495 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | (* (Not Available)) | 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. Banaly Blaise allows following entities to bill medicare on her behalf.
Entity Name | Mtca Psychological Services P.a. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1740552322 PECOS PAC ID: 6406010834 Enrollment ID: O20120614000204 |
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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. Banaly Blaise 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 |
Banaly Blaise, LCSW 8430 Rose Groves Rd, Orlando, FL 32818-5689 Ph: () - | Banaly Blaise, LCSW 8430 Rose Groves Rd, Orlando, FL 32818-5689 Ph: (407) 859-2882 |
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