Mary Kathleen Drake, AUD CCCA is a medicare enrolled "Audiologist" provider in Moorhead, Minnesota. Her current practice location is
1104 7th Ave South, Msum Box 119, Moorhead, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(218) 477-5953.
Mary Kathleen Drake is licensed to practice in Minnesota (license number 7305) 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 1346332947.
Healthcare Provider's Profile
| Full Name | Mary Kathleen Drake |
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| Gender | Female |
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| Speciality | Audiologist |
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| Location | 1104 7th Ave South, Moorhead, Minnesota |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1346332947
- Provider Enumeration Date: 09/29/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 0143458109
- Enrollment ID: I20140121000803
Medical Identifiers
Medical identifiers for Mary Kathleen Drake such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1346332947 | NPI | - | NPPES |
| 54228 | Medicaid | ND | |
| 22624 | Other | ND | BCBS |
| 426S9DR | Other | MN | BCBS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 231H00000X | Audiologist | 7305 (Minnesota) | 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. Mary Kathleen Drake allows following entities to bill medicare on her behalf.
| Provider Name | Minnesota State Colleges & Universities |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1215000963
PECOS PAC ID: 2264334663
Enrollment ID: O20140121000489 |
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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. Mary Kathleen Drake 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 |
|---|
Mary Kathleen Drake, AUD CCCA
1104 7th Ave South, Msum Box 119,
Moorhead, MN 56563-0001
Ph: (218) 477-5953 | Mary Kathleen Drake, AUD CCCA
1104 7th Ave South, Msum Box 119,
Moorhead, MN 56563-0001
Ph: (218) 477-5953 |
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