Shelby Ann Brandsma, LCSW in West Bend, WI - Medicare Social Worker Provider

Shelby Ann Brandsma, LCSW is a medicare enrolled "Social Worker - Clinical" provider in West Bend, Wisconsin. Her current practice location is 111 E Washington St, West Bend, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (262) 338-2717.

Shelby Ann Brandsma is licensed to practice in Wisconsin (license number 9862-123) 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 1992458376.

Contact Information

	Shelby Ann Brandsma, LCSW
	111 E Washington St, West Bend, WI 53095-2571
	(262) 338-2717
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Shelby Ann Brandsma
Gender	Female
Speciality	Social Worker - Clinical
Location	111 E Washington St, West Bend, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1992458376
Provider Enumeration Date: 01/27/2022
Last Update Date: 11/26/2023

Medicare PECOS Information:

PECOS PAC ID: 8022403625
Enrollment ID: I20220317001541

Medical Identifiers

Medical identifiers for Shelby Ann Brandsma such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1992458376	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	9862-123 (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. Shelby Ann Brandsma allows following entities to bill medicare on her behalf.

Entity Name	Affiliated Clinical Services Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1851473698 PECOS PAC ID: 0244124899 Enrollment ID: O20040212000835

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. Shelby Ann Brandsma 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
Shelby Ann Brandsma, LCSW N6631 Thompson Rd, Beaver Dam, WI 53916-9411 Ph: (920) 296-0611	Shelby Ann Brandsma, LCSW 111 E Washington St, West Bend, WI 53095-2571 Ph: (262) 338-2717

Reviews and Comments

Social Worker in West Bend, WI

Tiffany Dubey, LCSW, SAC-IT Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 111 E Washington St, West Bend, WI 53095 Phone: 262-338-2717
Mr. Mical Gustave Schaffer, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 400 W River Dr, West Bend, WI 53090 Phone: 262-338-2717
Abby Louise Janssen, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 111 E Washington St, West Bend, WI 53095 Phone: 262-338-2717 Fax: 262-338-9767
Diana Azimov, APSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1622 Chestnut St, West Bend, WI 53095 Phone: 262-306-9800
Ryanne Beth Wendt, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 111 E Washington St, West Bend, WI 53095 Phone: 262-338-2717
Mrs. Amy R. Schumann, LSCW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1622 Chestnut St, West Bend, WI 53095 Phone: 262-338-9498
Stephanie Gudmunsen, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 333 E Washington St, Suite 2000, West Bend, WI 53095 Phone: 262-335-4545 Fax: 262-335-6827

Shelby Ann Brandsma, LCSW - Medicare Clinical Social Worker in West Bend, WI