Stacey Janelle Callis, is a medicare enrolled "Social Worker - Clinical" provider in Los Angeles, California. Her current practice location is
333 S Beaudry Ave, Los Angeles, California. You can reach out to her office (for appointments etc.) via phone at
(213) 241-3841.
Stacey Janelle Callis is licensed to practice in California (license number 106957) 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 1366911505.
Healthcare Provider's Profile
Full Name | Stacey Janelle Callis |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 333 S Beaudry Ave, 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: 1366911505
- Provider Enumeration Date: 11/16/2018
- Last Update Date: 02/23/2022
Medicare PECOS Information:
- PECOS PAC ID: 2365971884
- Enrollment ID: I20250129001987
Medical Identifiers
Medical identifiers for Stacey Janelle Callis such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1366911505 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 86777 (California) | Secondary |
1041C0700X | Social Worker - Clinical | 106957 (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. Stacey Janelle Callis allows following entities to bill medicare on her behalf.
Entity Name | Sud Specialty Group - Ca |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1972138238 PECOS PAC ID: 9537534177 Enrollment ID: O20230412001370 |
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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. Stacey Janelle Callis 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 |
Stacey Janelle Callis, 333 S Beaudry Ave, Los Angeles, CA 90017-1466 Ph: (213) 241-3841 | Stacey Janelle Callis, 333 S Beaudry Ave, Los Angeles, CA 90017-1466 Ph: (213) 241-3841 |
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