Nicole Kristina Lidstrom, LICSW in Mankato, MN - Medicare Social Worker Provider

Nicole Kristina Lidstrom, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Mankato, Minnesota. Her current practice location is 1025 Marsh St, Mankato, Minnesota. You can reach out to her office (for appointments etc.) via phone at (507) 594-2468.

Nicole Kristina Lidstrom is licensed to practice in Minnesota (license number 26622) 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 1033947601.

Contact Information

	Nicole Kristina Lidstrom, LICSW
	1025 Marsh St, Mankato, MN 56001-4752
	(507) 594-2468
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Nicole Kristina Lidstrom
Gender	Female
Speciality	Social Worker - Clinical
Location	1025 Marsh St, Mankato, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1033947601
Provider Enumeration Date: 07/24/2024
Last Update Date: 08/26/2024

Medicare PECOS Information:

PECOS PAC ID: 5991245615
Enrollment ID: I20240909004439

Medical Identifiers

Medical identifiers for Nicole Kristina Lidstrom such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1033947601	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	26622 (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. Nicole Kristina Lidstrom allows following entities to bill medicare on her behalf.

Entity Name	Mayo Clinic Health System-southwest Minnesota Region
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1578545422 PECOS PAC ID: 4688585771 Enrollment ID: O20031110000134

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. Nicole Kristina Lidstrom 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
Nicole Kristina Lidstrom, LICSW 1025 Marsh St, Mankato, MN 56001-4752 Ph: (507) 625-4031	Nicole Kristina Lidstrom, LICSW 1025 Marsh St, Mankato, MN 56001-4752 Ph: (507) 594-2468

Reviews and Comments

Social Worker in Mankato, MN

Lacy Osborne, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 100 Warren St # 324, Mankato, MN 56001 Phone: 507-227-4858 Fax: 507-519-2271
Michele J. Larson, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 104 Serra St, Mankato, MN 56001 Phone: 608-577-5742
Tammy M Gagnon, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 11 Civic Center Plz Ste 1615, Mankato, MN 56001 Phone: 507-345-4679 Fax: 507-345-8685
Anna Marie Johanson, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1400 Madison Ave Ste 352, Mankato, MN 56001 Phone: 507-387-3195
Carrie Ann Leggett, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1025 Marsh St, Mankato, MN 56001 Phone: 507-400-4706
Karen Hernandez, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 226 N Broad St Ste 101, Mankato, MN 56001 Phone: 507-931-8040 Fax: 507-931-8060

Nicole Kristina Lidstrom, LICSW - Medicare Clinical Social Worker in Mankato, MN