Shawn Rae Disterhaupt, in Brainerd, MN - Medicare Social Worker Provider

Shawn Rae Disterhaupt, is a medicare enrolled "Social Worker - Clinical" provider in Brainerd, Minnesota. His current practice location is 606 Front St, Brainerd, Minnesota. You can reach out to his office (for appointments etc.) via phone at (218) 232-6247.

Shawn Rae Disterhaupt is licensed to practice in Minnesota (license number 26111) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1942996087.

Contact Information

	Shawn Rae Disterhaupt,
	606 Front St, Brainerd, MN 56401-3602
	(218) 232-6247
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Shawn Rae Disterhaupt
Gender	Male
Speciality	Social Worker - Clinical
Location	606 Front St, Brainerd, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1942996087
Provider Enumeration Date: 04/12/2023
Last Update Date: 04/12/2023

Medicare PECOS Information:

PECOS PAC ID: 8729445986
Enrollment ID: I20230601003090

Medical Identifiers

Medical identifiers for Shawn Rae Disterhaupt such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1942996087	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	26111 (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. Shawn Rae Disterhaupt allows following entities to bill medicare on his behalf.

Entity Name	Northern Pines Mental Health Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1013904051 PECOS PAC ID: 8628979697 Enrollment ID: O20040114000463

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. Shawn Rae Disterhaupt 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
Shawn Rae Disterhaupt, 203 H St Ne, Brainerd, MN 56401-2404 Ph: () -	Shawn Rae Disterhaupt, 606 Front St, Brainerd, MN 56401-3602 Ph: (218) 232-6247

Reviews and Comments

Social Worker in Brainerd, MN

Donn C Beaubien, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 520 Nw 5th St, Brainerd, MN 56401 Phone: 218-829-3235 Fax: 218-829-1368
Miss Barbara Kay Parks, MED, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 523 N 3rd St, Brainerd, MN 56401 Phone: 218-828-7379 Fax: 218-828-7390
Mrs. Bethany Rose Nordby, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 823 Maple St, Brainerd, MN 56401 Phone: 218-454-4065 Fax: 218-454-1024
Amanda Mary Kampa, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 823 Maple St, Brainerd, MN 56401 Phone: 218-454-3826 Fax: 218-454-1024
Ashley Marie Heinz, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 823 Maple St, Brainerd, MN 56401 Phone: 218-454-3826 Fax: 218-454-1024
Mr. Shawn S Mcnally, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 823 Maple St, Brainerd, MN 56401 Phone: 218-454-3826 Fax: 218-454-1024
Ms. Lara Royer, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 716 E St Ne, Brainerd, MN 56401 Phone: 218-828-7379 Fax: 218-828-7390

Shawn Rae Disterhaupt, - Medicare Clinical Social Worker in Brainerd, MN