Gina Marie Theisz, LICSW in Buffalo, MN - Medicare Social Worker Provider

Gina Marie Theisz, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Buffalo, Minnesota. Her current practice location is 308 12th Ave S, Buffalo, Minnesota. You can reach out to her office (for appointments etc.) via phone at (763) 682-4400.

Gina Marie Theisz is licensed to practice in Minnesota (license number 18283) 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 1407158496.

Contact Information

	Gina Marie Theisz, LICSW
	308 12th Ave S, Buffalo, MN 55313-2321
	(763) 682-4400
	(763) 682-1353

Map and Direction

Healthcare Provider's Profile

Full Name	Gina Marie Theisz
Gender	Female
Speciality	Social Worker - Clinical
Location	308 12th Ave S, Buffalo, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1407158496
Provider Enumeration Date: 11/23/2010
Last Update Date: 08/30/2011

Medicare PECOS Information:

PECOS PAC ID: 2365628534
Enrollment ID: I20110524000419

Medical Identifiers

Medical identifiers for Gina Marie Theisz such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1407158496	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	18283 (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. Gina Marie Theisz allows following entities to bill medicare on her behalf.

Entity Name	Central Minnesota Mental Health Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1831177195 PECOS PAC ID: 4486555877 Enrollment ID: O20040119000248

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. Gina Marie Theisz 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
Gina Marie Theisz, LICSW 1321 13th St N, Saint Cloud, MN 56303-2613 Ph: (320) 252-5010	Gina Marie Theisz, LICSW 308 12th Ave S, Buffalo, MN 55313-2321 Ph: (763) 682-4400

Reviews and Comments

Social Worker in Buffalo, MN

Stephanie E Barnes, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 308 12th Ave S, Buffalo, MN 55313 Phone: 763-682-4400 Fax: 763-682-1353
Mrs. Erica Rose Creighton, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 303 Catlin St, Buffalo, MN 55313 Phone: 763-682-5225
Androniki Kokkali, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 308 12th Ave S, Buffalo, MN 55313 Phone: 763-682-4400 Fax: 763-682-1353
Marah Rae Walker, MSW, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 308 12th Ave S, Buffalo, MN 55313 Phone: 763-682-4400
Richelle H Kramer, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1801 3rd Ave Sw, Buffalo, MN 55313 Phone: 612-269-9052
Ms. Amy Clark, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 102 Marty Dr, Buffalo, MN 55313 Phone: 763-682-5420 Fax: 763-682-5803

Gina Marie Theisz, LICSW - Medicare Clinical Social Worker in Buffalo, MN