Katie Jacoby Mccracken, CAPSW, SAC-IT is a medicare enrolled "Social Worker" provider in Green Bay, Wisconsin. Her current practice location is
300 Crooks St, Green Bay, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(920) 436-6800.
Katie Jacoby Mccracken is licensed to practice in Wisconsin (license number 130643) 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 1669004198.
Healthcare Provider's Profile
| Full Name | Katie Jacoby Mccracken |
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| Gender | Female |
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| Speciality | Social Worker |
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| Location | 300 Crooks St, Green Bay, 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: 1669004198
- Provider Enumeration Date: 02/12/2020
- Last Update Date: 10/01/2021
Medicare PECOS Information:
- PECOS PAC ID: 4082078183
- Enrollment ID: I20230907002737
Medical Identifiers
Medical identifiers for Katie Jacoby Mccracken such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1669004198 | NPI | - | NPPES |
| 1669004198 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 17661 (Wisconsin) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 16558 (Wisconsin) | Secondary |
| 104100000X | Social Worker | 130643 (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. Katie Jacoby Mccracken allows following entities to bill medicare on her behalf.
| Entity Name | Vivent Health Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1982654091
PECOS PAC ID: 1052308376
Enrollment ID: O20040428001271 |
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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. Katie Jacoby Mccracken 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 |
|---|
Katie Jacoby Mccracken, CAPSW, SAC-IT
Po Box 22308,
Green Bay, WI 54305-2308
Ph: (920) 436-6800 | Katie Jacoby Mccracken, CAPSW, SAC-IT
300 Crooks St,
Green Bay, WI 54301-4527
Ph: (920) 436-6800 |
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