Johnathan Koelsch, LMSW is a medicare enrolled "Social Worker - Clinical" provider in Ammon, Idaho. He graduated from healthcare school in 2012 and has 12 years of diverse experience with area of expertise as Clinical Social Worker. He is a member of the group practice 4 Pillars Of Success Llc and his current practice location is
1675 Curlew Dr, Ammon, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 523-5319.
Johnathan Koelsch is licensed to practice in Idaho (license number LCSW-38371) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1326409913.
Healthcare Provider's Profile
| Full Name | Johnathan Koelsch |
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| Gender | Male |
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| Speciality | Clinical Social Worker |
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| Experience | 12 Years |
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| Location | 1675 Curlew Dr, Ammon, Idaho |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Johnathan Koelsch graduated from medical school in 2012
NPI Data:
- NPI Number: 1326409913
- Provider Enumeration Date: 03/10/2016
- Last Update Date: 08/09/2023
Medicare PECOS Information:
- PECOS PAC ID: 9931442696
- Enrollment ID: I20190521000295
Medical Identifiers
Medical identifiers for Johnathan Koelsch such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1326409913 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | LMSW-34382 (Idaho) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCSW-38371 (Idaho) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| 4 Pillars Of Success Llc | 4688027188 | 10 |
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. Johnathan Koelsch allows following entities to bill medicare on his behalf.
| Entity Name | Badger Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1619134277
PECOS PAC ID: 3173794187
Enrollment ID: O20110923000401 |
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| Entity Name | 4 Pillars Of Success Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1619134277
PECOS PAC ID: 4688027188
Enrollment ID: O20240131004474 |
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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. Johnathan Koelsch 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 |
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Johnathan Koelsch, LMSW
Po Box 2106,
Idaho Falls, ID 83403-2106
Ph: (208) 523-5319 | Johnathan Koelsch, LMSW
1675 Curlew Dr,
Ammon, ID 83406-4850
Ph: (208) 523-5319 |
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