Emily E Green, MSW is a medicare enrolled "Social Worker - Clinical" provider in Jefferson, Wisconsin. Her current practice location is
1541 Annex Rd, Jefferson, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(920) 674-5961.
Emily E Green is licensed to practice in Wisconsin (license number 132496) 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 1669042503.
Healthcare Provider's Profile
| Full Name | Emily E Green |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 1541 Annex Rd, Jefferson, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1669042503
- Provider Enumeration Date: 07/01/2021
- Last Update Date: 05/05/2023
Medicare PECOS Information:
- PECOS PAC ID: 5890138788
- Enrollment ID: I20240207003484
Medical Identifiers
Medical identifiers for Emily E Green such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1669042503 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 19778 (Wisconsin) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Secondary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 132496 (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. Emily E Green allows following entities to bill medicare on her behalf.
| Entity Name | Jefferson County |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1275614919
PECOS PAC ID: 2264496801
Enrollment ID: O20041115000371 |
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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. Emily E Green 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 |
|---|
Emily E Green, MSW
1541 Annex Rd,
Jefferson, WI 53549-9803
Ph: (920) 674-5961 | Emily E Green, MSW
1541 Annex Rd,
Jefferson, WI 53549-9803
Ph: (920) 674-5961 |
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