Bryson Dale Blackburn, LCSW - Medicare in Arcadia, FL

Bryson Dale Blackburn, LCSW is a medicare enrolled "Counselor - Mental Health" provider in Arcadia, Florida. His current practice location is 725 N 12th Ave, Arcadia, Florida. You can reach out to his office (for appointments etc.) via phone at (863) 494-1242.

Bryson Dale Blackburn is licensed to practice in Florida (license number SW14904) 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 1891208393.

Contact Information

Bryson Dale Blackburn, LCSW
725 N 12th Ave,
Arcadia, FL 34266-8752
(863) 494-1242
(863) 491-0466



Healthcare Provider's Profile

Full NameBryson Dale Blackburn
GenderMale
SpecialityCounselor - Mental Health
Location725 N 12th Ave, Arcadia, Florida
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1891208393
  • Provider Enumeration Date: 11/07/2017
  • Last Update Date: 07/21/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 3971862418
  • Enrollment ID: I20180109001646

Medical Identifiers

Medical identifiers for Bryson Dale Blackburn such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1891208393NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical SW14904 (Florida)Secondary
101YM0800XCounselor - Mental Health SW14904 (Florida)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. Bryson Dale Blackburn allows following entities to bill medicare on his behalf.
Entity NameMcr Health Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1255376000
PECOS PAC ID: 7214847995
Enrollment ID: O20040126000213

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Entity NameRefresh Canopy Cove, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1730661752
PECOS PAC ID: 3779822119
Enrollment ID: O20190304000354

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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. Bryson Dale Blackburn 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 AddressPractice Location Address
Bryson Dale Blackburn, LCSW
700 8th Ave W Ste 101,
Palmetto, FL 34221-4737

Ph: (941) 776-4000
Bryson Dale Blackburn, LCSW
725 N 12th Ave,
Arcadia, FL 34266-8752

Ph: (863) 494-1242

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