Jesse M Crowder, is a medicare enrolled "Social Worker - Clinical" provider in Lakewood, Ohio. His current practice location is
14805 Detroit Ave Ste 200c, Lakewood, Ohio. You can reach out to his office (for appointments etc.) via phone at
(216) 223-8083.
Jesse M Crowder is licensed to practice in Ohio (license number I.2304984-SUPV) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1417458134.
Healthcare Provider's Profile
| Full Name | Jesse M Crowder |
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| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 14805 Detroit Ave Ste 200c, Lakewood, Ohio |
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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: 1417458134
- Provider Enumeration Date: 02/27/2018
- Last Update Date: 05/13/2026
Medicare PECOS Information:
- PECOS PAC ID: 9931541133
- Enrollment ID: I20240520001957
Medical Identifiers
Medical identifiers for Jesse M Crowder such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1417458134 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | LICDC.162220 (Ohio) | Secondary |
| 104100000X | Social Worker | S.2106128 (Ohio) | Secondary |
| 1041C0700X | Social Worker - Clinical | I.2304984-SUPV (Ohio) | 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. Jesse M Crowder allows following entities to bill medicare on his behalf.
| Entity Name | Signature Health, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1679767289 PECOS PAC ID: 8628970985 Enrollment ID: O20040126000762 |
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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. Jesse M Crowder 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 |
Jesse M Crowder, 14805 Detroit Ave Ste 200c, Lakewood, OH 44107-3921 Ph: (216) 223-8083 | Jesse M Crowder, 14805 Detroit Ave Ste 200c, Lakewood, OH 44107-3921 Ph: (216) 223-8083 |
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