Shannon Martina Rapalo Medina, LICSW in Fridley, MN

Shannon Martina Rapalo Medina, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Fridley, Minnesota. Her current practice location is 5155 E River Rd Ste 401, Fridley, Minnesota. You can reach out to her office (for appointments etc.) via phone at (763) 913-9184.

Shannon Martina Rapalo Medina is licensed to practice in Minnesota (license number 26538) 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 1104531458.

Contact Information

	Shannon Martina Rapalo Medina, LICSW
	5155 E River Rd Ste 401, Fridley, MN 55421-3777
	(763) 913-9184
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Shannon Martina Rapalo Medina
Gender	Female
Speciality	Social Worker - Clinical
Location	5155 E River Rd Ste 401, Fridley, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1104531458
Provider Enumeration Date: 01/20/2023
Last Update Date: 01/20/2023

Medicare PECOS Information:

PECOS PAC ID: 4486008455
Enrollment ID: I20230925001907

Medical Identifiers

Medical identifiers for Shannon Martina Rapalo Medina such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1104531458	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	26538 (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. Shannon Martina Rapalo Medina allows following entities to bill medicare on her behalf.

Entity Name	Your Story Matters Counseling
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396424446 PECOS PAC ID: 2668826637 Enrollment ID: O20230925001859

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. Shannon Martina Rapalo Medina 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
Shannon Martina Rapalo Medina, LICSW 7850 Zane Ave N Apt 108, Brooklyn Park, MN 55443-3032 Ph: (612) 293-0635	Shannon Martina Rapalo Medina, LICSW 5155 E River Rd Ste 401, Fridley, MN 55421-3777 Ph: (763) 913-9184

Reviews and Comments

Social Worker in Fridley, MN

Kimberly E Schultz, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1250 Moore Lake Dr E Ste 152, Fridley, MN 55432 Phone: 612-389-2332 Fax: 612-389-2338
Charlette Kay Carlotto, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6401 University Ave Ne, Suite 304, Fridley, MN 55432 Phone: 651-769-6250 Fax: 651-769-6299
Carolyn Sarah Menger, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1250 Moore Lake Dr E Ste 152, Fridley, MN 55432 Phone: 612-389-2332 Fax: 612-389-2338
Mrs. Erin Kristine Church, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 500 Osborne Rd Ne Ste 255, Fridley, MN 55432 Phone: 763-786-6011
Megan Hickenbottom, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 520 Osborne Rd Ne, Fridley, MN 55432 Phone: 763-236-7958
Amanda Boelen Harrington, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 7954 University Ave Ne, Fridley, MN 55432 Phone: 763-780-3036

Shannon Martina Rapalo Medina, LICSW - Medicare Clinical Social Worker in Fridley, MN