Shannon Rae Lutz, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Hurley, Wisconsin. Her current practice location is
115 5th Ave N, Hurley, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(153) 291-2887.
Shannon Rae Lutz is licensed to practice in Wisconsin (license number 10176) 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 1891931895.
Healthcare Provider's Profile
Full Name | Shannon Rae Lutz |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 115 5th Ave N, Hurley, 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: 1891931895
- Provider Enumeration Date: 12/21/2008
- Last Update Date: 11/01/2023
Medicare PECOS Information:
- PECOS PAC ID: 6709241904
- Enrollment ID: I20230421001819
Medical Identifiers
Medical identifiers for Shannon Rae Lutz such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1891931895 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | 6801090552 (Michigan) | Secondary |
1041C0700X | Social Worker - Clinical | 10176 (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. Shannon Rae Lutz allows following entities to bill medicare on her behalf.
Entity Name | The Lakes Community Health Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1811178825 PECOS PAC ID: 0840366654 Enrollment ID: O20101019000186 |
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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. Shannon Rae Lutz 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 Rae Lutz, LCSW 15735 W Us Highway 63, Hayward, WI 54843-6475 Ph: (715) 934-0710 | Shannon Rae Lutz, LCSW 115 5th Ave N, Hurley, WI 54534-1208 Ph: (153) 291-2887 |
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