Mr Michael Chippolla, LCSW ACADC is a medicare enrolled "Social Worker - Clinical" provider in Boise, Idaho. His current practice location is
4477 W Emerald St, Boise, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 713-5250.
Mr Michael Chippolla is licensed to practice in Idaho (license number LCSW35126) 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 1679969976.
Healthcare Provider's Profile
| Full Name | Mr Michael Chippolla |
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| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 4477 W Emerald St, Boise, Idaho |
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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: 1679969976
- Provider Enumeration Date: 04/13/2015
- Last Update Date: 03/17/2017
Medicare PECOS Information:
- PECOS PAC ID: 0547577025
- Enrollment ID: I20150916000368
Medical Identifiers
Medical identifiers for Mr Michael Chippolla such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1679969976 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | ACADC-778 (Idaho) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCSW35126 (Idaho) | 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. Mr Michael Chippolla allows following entities to bill medicare on his behalf.
| Entity Name | Human Supports Of Idaho |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1922340124
PECOS PAC ID: 0244485894
Enrollment ID: O20130305000118 |
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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. Mr Michael Chippolla 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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Mr Michael Chippolla, LCSW ACADC
4477 W Emerald St,
Boise, ID 83706-2000
Ph: (208) 713-5250 | Mr Michael Chippolla, LCSW ACADC
4477 W Emerald St,
Boise, ID 83706-2000
Ph: (208) 713-5250 |
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