Elise Broderick Quam, MSW, LICSW in Eagan, MN - Medicare Social Worker Provider

Elise Broderick Quam, MSW, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Eagan, Minnesota. Her current practice location is 3450 Oleary Ln, Eagan, Minnesota. You can reach out to her office (for appointments etc.) via phone at (651) 454-0114.

Elise Broderick Quam is licensed to practice in Minnesota (license number 25498) 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 1891269155.

Contact Information

	Elise Broderick Quam, MSW, LICSW
	3450 Oleary Ln, Eagan, MN 55123
	(651) 454-0114
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Elise Broderick Quam
Gender	Female
Speciality	Social Worker - Clinical
Location	3450 Oleary Ln, Eagan, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1891269155
Provider Enumeration Date: 01/18/2019
Last Update Date: 01/18/2019

Medicare PECOS Information:

PECOS PAC ID: 7810238367
Enrollment ID: I20190409003460

Medical Identifiers

Medical identifiers for Elise Broderick Quam such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1891269155	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	25498 (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. Elise Broderick Quam allows following entities to bill medicare on her behalf.

Entity Name	Eagan Counseling Clinic
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1144311184 PECOS PAC ID: 2860304045 Enrollment ID: O20031105000326

Entity Name	Collaborative Counseling, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1598034324 PECOS PAC ID: 3678711900 Enrollment ID: O20160909002528

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. Elise Broderick Quam 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
Elise Broderick Quam, MSW, LICSW 3450 Oleary Ln, Eagan, MN 55123-2340 Ph: (651) 365-8628	Elise Broderick Quam, MSW, LICSW 3450 Oleary Ln, Eagan, MN 55123 Ph: (651) 454-0114

Reviews and Comments

Social Worker in Eagan, MN

Angela Maureen Holmquist, LICSW, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3618 Lakeview Trl, Eagan, MN 55122 Phone: 651-528-1449
Mr. Todd Borstad, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3450 O'leary Lane, Eagan, MN 55123 Phone: 651-454-0114 Fax: 651-454-3492
Jocelyn Skye Byrd, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 3450 Oleary Ln, Eagan, MN 55123 Phone: 651-365-8264
Sondra Decker Fruzzetti, M.S.W., LSCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 3450 Oleary Ln, Eagan, MN 55123 Phone: 651-454-0114 Fax: 651-454-3492
Clare Louise Macdonald-sexton, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1885 Plaza Dr, Eagan, MN 55122 Phone: 952-993-4001
Anne Bushnell, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 3460 Washington Dr Ste 200, Eagan, MN 55122 Phone: 651-232-3339
Donna Jean Snetting, MSW LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3460 Washington Drive, Suite 200, Eagan, MN 55122 Phone: 651-769-6200 Fax: 651-769-6249

Elise Broderick Quam, MSW, LICSW - Medicare Clinical Social Worker in Eagan, MN