Mr Marvin Fangman, MA, IAADC is a medicare enrolled "Counselor - Addiction (substance Use Disorder)" provider in Prairie City, Iowa. His current practice location is
501 North Sherman, Prairie City, Iowa. You can reach out to his office (for appointments etc.) via phone at
(515) 994-3562.
Mr Marvin Fangman is licensed to practice in Iowa (license number 10167) 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 1245613108.
Healthcare Provider's Profile
| Full Name | Mr Marvin Fangman |
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| Gender | Male |
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| Speciality | Counselor - Addiction (substance Use Disorder) |
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| Location | 501 North Sherman, Prairie City, Iowa |
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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: 1245613108
- Provider Enumeration Date: 07/09/2015
- Last Update Date: 07/09/2015
Medicare PECOS Information:
- PECOS PAC ID: 7214216274
- Enrollment ID: I20161115000276
Medical Identifiers
Medical identifiers for Mr Marvin Fangman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1245613108 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 10167 (Iowa) | Primary |
| 104100000X | Social Worker | 0-24094-1B (Virgin Island) | Secondary |
| 1041C0700X | Social Worker - Clinical | 01546 (Iowa) | Secondary |
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. Mr Marvin Fangman allows following entities to bill medicare on his behalf.
| Entity Name | Frederiksted Health Care, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1437215134
PECOS PAC ID: 7911818778
Enrollment ID: O20100720000267 |
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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. Mr Marvin Fangman 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 |
|---|
Mr Marvin Fangman, MA, IAADC
15806 Wildwood Drive,
Clive, IA 50325
Ph: (515) 371-1166 | Mr Marvin Fangman, MA, IAADC
501 North Sherman,
Prairie City, IA 50228
Ph: (515) 994-3562 |
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