Ms Nancy Shea, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Lake Mills, Wisconsin. Her current practice location is
200 E Tyranena Park Rd, Lake Mills, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(920) 648-8393.
Ms Nancy Shea is licensed to practice in Wisconsin (license number 1697) 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 1265420491.
Healthcare Provider's Profile
| Full Name | Ms Nancy Shea |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 200 E Tyranena Park Rd, Lake Mills, Wisconsin |
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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: 1265420491
- Provider Enumeration Date: 10/11/2005
- Last Update Date: 05/04/2021
Medicare PECOS Information:
- PECOS PAC ID: 3375898570
- Enrollment ID: I20180717002996
Medical Identifiers
Medical identifiers for Ms Nancy Shea such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1265420491 | NPI | - | NPPES |
| 39634600 | Medicaid | WI | |
| 1011361 | Other | WI | PHYSICIANS PLUS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1041C0700X | Social Worker - Clinical | 1697 (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. Ms Nancy Shea allows following entities to bill medicare on her behalf.
| Entity Name | University Of Wisconsin Medical Foundation Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1598784555
PECOS PAC ID: 6608785464
Enrollment ID: O20031111000435 |
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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. Ms Nancy Shea 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 |
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Ms Nancy Shea, LCSW
611 Sherman Ave E,
Fort Atkinson, WI 53538-1960
Ph: (920) 568-6558 | Ms Nancy Shea, LCSW
200 E Tyranena Park Rd,
Lake Mills, WI 53551-9678
Ph: (920) 648-8393 |
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