Autumn Michelle Phenow, MSW, LICSW in Fridley, MN - Medicare Clinical Social Worker Provider

Autumn Michelle Phenow, MSW, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Fridley, Minnesota. She graduated from medical school in 2016 and has 9 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Fairview Express Care and her current practice location is 6341 University Ave Ne, Fridley, Minnesota. You can reach out to her office (for appointments etc.) via phone at (612) 672-6999.

Autumn Michelle Phenow is licensed to practice in Minnesota (license number 22651) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1154980068.

Contact Information

	Autumn Michelle Phenow, MSW, LICSW
	6341 University Ave Ne, Fridley, MN 55432-4946
	(612) 672-6999
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Autumn Michelle Phenow
Gender	Female
Speciality	Clinical Social Worker
Experience	9 Years
Location	6341 University Ave Ne, Fridley, Minnesota
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Autumn Michelle Phenow graduated from medical school in 2016

NPI Data:

NPI Number: 1154980068
Provider Enumeration Date: 06/13/2019
Last Update Date: 08/22/2019

Medicare PECOS Information:

PECOS PAC ID: 7911235866
Enrollment ID: I20190829004029

Medical Identifiers

Medical identifiers for Autumn Michelle Phenow such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1154980068	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	22651 (Minnesota)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Fairview Express Care	3375645179	1537

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. Autumn Michelle Phenow allows following entities to bill medicare on her behalf.

Entity Name	Fairview Health Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1013994359 PECOS PAC ID: 1951213057 Enrollment ID: O20031105000461

Entity Name	Fairview Express Care
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1053952606 PECOS PAC ID: 3375645179 Enrollment ID: O20081028000548

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. Autumn Michelle Phenow 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
Autumn Michelle Phenow, MSW, LICSW 2785 White Bear Ave N Ste 403, Maplewood, MN 55109-1327 Ph: (651) 395-5775	Autumn Michelle Phenow, MSW, LICSW 6341 University Ave Ne, Fridley, MN 55432-4946 Ph: (612) 672-6999

Reviews and Comments

Social Worker in Fridley, MN

Kimberly E Schultz, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1250 Moore Lake Dr E Ste 152, Fridley, MN 55432 Phone: 612-389-2332 Fax: 612-389-2338
Charlette Kay Carlotto, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6401 University Ave Ne, Suite 304, Fridley, MN 55432 Phone: 651-769-6250 Fax: 651-769-6299
Carolyn Sarah Menger, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1250 Moore Lake Dr E Ste 152, Fridley, MN 55432 Phone: 612-389-2332 Fax: 612-389-2338
Mrs. Erin Kristine Church, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 500 Osborne Rd Ne Ste 255, Fridley, MN 55432 Phone: 763-786-6011
Megan Hickenbottom, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 520 Osborne Rd Ne, Fridley, MN 55432 Phone: 763-236-7958
Amanda Boelen Harrington, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 7954 University Ave Ne, Fridley, MN 55432 Phone: 763-780-3036
Shannon Martina Rapalo Medina, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 5155 E River Rd Ste 401, Fridley, MN 55421 Phone: 763-913-9184

Autumn Michelle Phenow, MSW, LICSW - Medicare Clinical Social Worker in Fridley, MN