John Ambrose, in Coon Rapids, MN - Medicare Counselor Provider

John Ambrose, is a medicare enrolled "Counselor - Addiction (substance Use Disorder)" provider in Coon Rapids, Minnesota. His current practice location is 11660 Round Lake Blvd Nw, Coon Rapids, Minnesota. You can reach out to his office (for appointments etc.) via phone at (612) 562-6790.

John Ambrose is licensed to practice in Minnesota (license number 304566) 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 1881364008.

Contact Information

	John Ambrose,
	11660 Round Lake Blvd Nw, Coon Rapids, MN 55433-2638
	(612) 562-6790
	(763) 767-0912

Map and Direction

Healthcare Provider's Profile

Full Name	John Ambrose
Gender	Male
Speciality	Counselor - Addiction (substance Use Disorder)
Location	11660 Round Lake Blvd Nw, Coon Rapids, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1881364008
Provider Enumeration Date: 09/18/2021
Last Update Date: 09/18/2021

Medicare PECOS Information:

PECOS PAC ID: 7315399854
Enrollment ID: I20240119001992

Medical Identifiers

Medical identifiers for John Ambrose such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1881364008	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YA0400X	Counselor - Addiction (substance Use Disorder)	304566 (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. John Ambrose allows following entities to bill medicare on his behalf.

Entity Name	Nystrom & Associates Ltd
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396750188 PECOS PAC ID: 6406752492 Enrollment ID: O20031210000592

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. John Ambrose 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
John Ambrose, 11660 Round Lake Blvd Nw, Coon Rapids, MN 55433-2638 Ph: (612) 562-6790	John Ambrose, 11660 Round Lake Blvd Nw, Coon Rapids, MN 55433-2638 Ph: (612) 562-6790

Reviews and Comments

Counselor in Coon Rapids, MN

Abigail Fletcher, Counselor Medicare: Medicare Enrolled Practice Location: 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433 Phone: 763-767-3350
Mrs. Nikisha Lynnette Simmons-maclin, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 10026 University Ave Nw Ste 103, Coon Rapids, MN 55448 Phone: 612-636-9677
Adam Palowski, LPCC Counselor Medicare: Medicare Enrolled Practice Location: 10077 Dogwood St Nw, Coon Rapids, MN 55448 Phone: 612-676-1604
Charles Lochner, MA Counselor Medicare: Medicare Enrolled Practice Location: 11660 Round Lake Blvd Nw, Coon Rapids, MN 55433 Phone: 763-767-3350 Fax: 763-767-0912
Ms. Kristal Ficzeri, MA Counselor Medicare: Medicare Enrolled Practice Location: 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433 Phone: 763-767-3350
Calsi Gilbertson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 11660 Round Lake Blvd Nw, Coon Rapids, MN 55433 Phone: 763-767-3350
Hong Fa Thao, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 9120 Springbrook Dr Nw, Coon Rapids, MN 55433 Phone: 612-767-7222

John Ambrose, - Medicare Counselor in Coon Rapids, MN