Individual provider Active NPI

Bacilio H Padilla, LICSW

  • Social Worker
  • Yakima, WA
National Provider Identifier
1811057243
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LW60282651 Issued in WA
Practice address
303 E D St
Yakima, WA 98901-2300
Phone
(509) 853-1300
Fax
(509) 966-3676
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LW60282651 WA Primary

Addresses

Primary practice location

303 E D St
Yakima, WA 98901-2300

Mailing address

303 E D St
Yakima, WA 98901-2300
Phone (509) 853-1300

Other identifiers 1

IdentifierTypeStateIssuer
2304837MedicaidWA

Other names 1

  • Bacilio Hernandez Padilla Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170203001851 WA Practitioner - Clinical Social Worker 6406139161 Reassigns benefits to 1 organization
I20200701001281 TX Practitioner - Clinical Social Worker 6406139161 Practice locations: Mission, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Charities of the Diocese of YakimaGroup PAC ID 2163594797, 13 clinicians

Practice addresses (Care Compare)

145 S Worthen St
Wenatchee, WA 98801-3081
Phone (509) 662-6761

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63207TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities of the Diocese of Yakima CurrentSince Dec 31, 2016 Accepting new patients
Childrens Advocacy Center of Hidalgo County Inc PastSince Jul 12, 2017 Accepting new patients
Mission Psychological Center, P.a. PastSince Apr 1, 1998 Accepting new patients

Locations

145 S Worthen St
Wenatchee, WA 98801
Phone (509) 662-6712

5301 Tieton Dr
Ste C
Yakima, WA 98908
Phone (509) 965-7100

303 E D St
Yakima, WA 98901
Phone (509) 580-9303

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1811057243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E D ST",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989012300",
            "telephone_number": "509-853-1300",
            "fax_number": "509-966-3676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E D ST",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989012300",
            "telephone_number": "509-853-1300",
            "fax_number": "509-966-3676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADILLA",
        "first_name": "BACILIO",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW60282651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2304837",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BACILIO",
            "last_name": "PADILLA",
            "middle_name": "HERNANDEZ",
            "credential": "LICSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.