Priscilla Sharon-georgia Bake, LMSW is a medicare enrolled "Social Worker - Clinical" provider in Hailey, Idaho. She graduated from healthcare school in 2022 and has 3 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice St Lukes Clinic - Wood River Llc and her current practice location is
1450 Aviation Dr, Hailey, Idaho. You can reach out to her office (for appointments etc.) via phone at
(208) 727-8970.
Priscilla Sharon-georgia Bake is licensed to practice in Idaho (license number 8861956) 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 1770225112.
Healthcare Provider's Profile
| Full Name | Priscilla Sharon-georgia Bake |
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| Gender | Female |
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| Speciality | Clinical Social Worker |
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| Experience | 3 Years |
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| Location | 1450 Aviation Dr, Hailey, Idaho |
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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:
- Priscilla Sharon-georgia Bake graduated from medical school in 2022
NPI Data:
- NPI Number: 1770225112
- Provider Enumeration Date: 04/07/2022
- Last Update Date: 12/03/2024
Medicare PECOS Information:
- PECOS PAC ID: 9739615345
- Enrollment ID: I20241205003745
Medical Identifiers
Medical identifiers for Priscilla Sharon-georgia Bake such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1770225112 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | LMSW-42222 (Idaho) | Secondary |
| 104100000X | Social Worker | LSW-40865 (Idaho) | Secondary |
| 104100000X | Social Worker | LMSW-42222 (Idaho) | Secondary |
| 1041C0700X | Social Worker - Clinical | 8861956 (Idaho) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| St Lukes Clinic - Wood River Llc | 3173783818 | 58 |
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. Priscilla Sharon-georgia Bake allows following entities to bill medicare on her behalf.
| Entity Name | St Lukes Clinic - Wood River Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1972891604
PECOS PAC ID: 3173783818
Enrollment ID: O20120404000474 |
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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. Priscilla Sharon-georgia Bake 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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Priscilla Sharon-georgia Bake, LMSW
190 E Bannock St,
Boise, ID 83712-6241
Ph: () - | Priscilla Sharon-georgia Bake, LMSW
1450 Aviation Dr,
Hailey, ID 83333-8785
Ph: (208) 727-8970 |
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