Timothy Fairbanks, LISW is a medicare enrolled "Social Worker - Clinical" provider in North Liberty, Iowa. He graduated from healthcare school in 2016 and has 10 years of diverse experience with area of expertise as Clinical Social Worker. He is a member of the group practice Psychiatric Associates Of Iowa, Pc and his current practice location is
1290 Jordan St, North Liberty, Iowa. You can reach out to his office (for appointments etc.) via phone at
(319) 249-0307.
Timothy Fairbanks is licensed to practice in Iowa (license number 081394) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1619693785.
Healthcare Provider's Profile
| Full Name | Timothy Fairbanks |
|---|
| Gender | Male |
|---|
| Speciality | Clinical Social Worker |
|---|
| Experience | 10 Years |
|---|
| Location | 1290 Jordan St, North Liberty, Iowa |
|---|
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Timothy Fairbanks graduated from medical school in 2016
NPI Data:
- NPI Number: 1619693785
- Provider Enumeration Date: 10/19/2022
- Last Update Date: 10/17/2024
Medicare PECOS Information:
- PECOS PAC ID: 3274066618
- Enrollment ID: I20241024000523
Medical Identifiers
Medical identifiers for Timothy Fairbanks such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1619693785 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | 081394 (Iowa) | Secondary |
| 1041C0700X | Social Worker - Clinical | 081394 (Iowa) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Psychiatric Associates Of Iowa, Pc | 9638550544 | 33 |
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. Timothy Fairbanks allows following entities to bill medicare on his behalf.
| Entity Name | Psychiatric Associates Of Iowa, Pc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1568121457
PECOS PAC ID: 9638550544
Enrollment ID: O20220722001283 |
|---|
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. Timothy Fairbanks 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 |
|---|
Timothy Fairbanks, LISW
1900 Silver Lake Rd Nw Ste 110,
New Brighton, MN 55112-1789
Ph: (651) 628-9566 | Timothy Fairbanks, LISW
1290 Jordan St,
North Liberty, IA 52317-8020
Ph: (319) 249-0307 |
Reviews and Comments