Devon Lacey Medina, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Los Angeles, California. Her current practice location is
1891 Effie St, Los Angeles, California. You can reach out to her office (for appointments etc.) via phone at
(818) 644-9187.
Devon Lacey Medina is licensed to practice in California (license number 127667) 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 1598332553.
Healthcare Provider's Profile
Full Name | Devon Lacey Medina |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 1891 Effie St, Los Angeles, California |
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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: 1598332553
- Provider Enumeration Date: 06/08/2021
- Last Update Date: 01/07/2025
Medicare PECOS Information:
- PECOS PAC ID: 3173052974
- Enrollment ID: I20250123001873
Medical Identifiers
Medical identifiers for Devon Lacey Medina such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1598332553 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 102559 (California) | Secondary |
225400000X | Rehabilitation Practitioner | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | 127667 (California) | 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. Devon Lacey Medina allows following entities to bill medicare on her behalf.
Entity Name | Gateways Hospital & Mental Health Center |
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Entity Type | Part B Supplier - Hospital Department(s) |
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Entity Identifiers | NPI Number: 1720151137 PECOS PAC ID: 8921136912 Enrollment ID: O20100512000761 |
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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. Devon Lacey Medina 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 |
Devon Lacey Medina, LCSW 1891 Effie St, Los Angeles, CA 90026-1711 Ph: (323) 644-2000 | Devon Lacey Medina, LCSW 1891 Effie St, Los Angeles, CA 90026-1711 Ph: (818) 644-9187 |
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