Diana Bastidas Vallejo, MSW, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Yulee, Florida. She graduated from healthcare school in 2020 and has 6 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Grow Healthcare Group Pa and her current practice location is
96028 Sweetbriar Ln, Yulee, Florida. You can reach out to her office (for appointments etc.) via phone at
(904) 649-1946.
Diana Bastidas Vallejo is licensed to practice in Florida (license number SW23714) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1902629660.
Healthcare Provider's Profile
| Full Name | Diana Bastidas Vallejo |
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| Gender | Female |
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| Speciality | Clinical Social Worker |
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| Experience | 6 Years |
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| Location | 96028 Sweetbriar Ln, Yulee, Florida |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Diana Bastidas Vallejo graduated from medical school in 2020
NPI Data:
- NPI Number: 1902629660
- Provider Enumeration Date: 11/01/2024
- Last Update Date: 03/10/2026
Medicare PECOS Information:
- PECOS PAC ID: 3577081694
- Enrollment ID: I20250513001632
Medical Identifiers
Medical identifiers for Diana Bastidas Vallejo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1902629660 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | SW23714 (Florida) | Secondary |
| 101YP2500X | Counselor - Professional | SW23714 (Florida) | Secondary |
| 1041C0700X | Social Worker - Clinical | SW23714 (Florida) | Primary |
| 104100000X | Social Worker | SW23714 (Florida) | Secondary |
| 102L00000X | Psychoanalyst | SW23714 (Florida) | Secondary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Grow Healthcare Group Pa | 3476961368 | 994 |
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. Diana Bastidas Vallejo allows following entities to bill medicare on her behalf.
| Entity Name | Grow Healthcare Group Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1245845932
PECOS PAC ID: 3476961368
Enrollment ID: O20210414000053 |
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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. Diana Bastidas Vallejo 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 |
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Diana Bastidas Vallejo, MSW, LCSW
96028 Sweetbriar Ln,
Yulee, FL 32097-6018
Ph: (904) 649-1946 | Diana Bastidas Vallejo, MSW, LCSW
96028 Sweetbriar Ln,
Yulee, FL 32097-6018
Ph: (904) 649-1946 |
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