Mary Goggins, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Waukesha, Wisconsin. Her current practice location is
2607 N Grandview Blvd, Suite 104, Waukesha, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(262) 402-7964.
Mary Goggins is licensed to practice in Wisconsin (license number 7947-123) 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 1033463849.
Healthcare Provider's Profile
| Full Name | Mary Goggins |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 2607 N Grandview Blvd, Waukesha, 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: 1033463849
- Provider Enumeration Date: 10/31/2012
- Last Update Date: 02/28/2014
Medicare PECOS Information:
- PECOS PAC ID: 5890137343
- Enrollment ID: I20240529002449
Medical Identifiers
Medical identifiers for Mary Goggins such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1033463849 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 15722-131 (Wisconsin) | Secondary |
| 1041C0700X | Social Worker - Clinical | 7947-123 (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. Mary Goggins allows following entities to bill medicare on her behalf.
| Entity Name | Brightside Medical Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1609335660
PECOS PAC ID: 3678948809
Enrollment ID: O20230425001219 |
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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. Mary Goggins 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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Mary Goggins, LCSW
2607 N Grandview Blvd, Suite 104,
Waukesha, WI 53188-1686
Ph: (262) 402-7964 | Mary Goggins, LCSW
2607 N Grandview Blvd, Suite 104,
Waukesha, WI 53188-1686
Ph: (262) 402-7964 |
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