Kandis Gallentine, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Salem, Wisconsin. Her current practice location is
8500 221st Ave, Salem, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(262) 995-8352.
Kandis Gallentine is licensed to practice in Wisconsin (license number 11230-123) 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 1275225450.
Healthcare Provider's Profile
Full Name | Kandis Gallentine |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 8500 221st Ave, Salem, Wisconsin |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1275225450
- Provider Enumeration Date: 05/24/2023
- Last Update Date: 05/24/2023
Medicare PECOS Information:
- PECOS PAC ID: 2062946049
- Enrollment ID: I20241113002938
Medical Identifiers
Medical identifiers for Kandis Gallentine such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1275225450 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | 11230-123 (Wisconsin) | 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. Kandis Gallentine allows following entities to bill medicare on her behalf.
Entity Name | Cornerstone Counseling Services Sc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1033127246 PECOS PAC ID: 1456256023 Enrollment ID: O20031205000446 |
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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. Kandis Gallentine 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 |
Kandis Gallentine, LCSW 8500 221st Ave, Salem, WI 53168-9351 Ph: (262) 995-8352 | Kandis Gallentine, LCSW 8500 221st Ave, Salem, WI 53168-9351 Ph: (262) 995-8352 |
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