Mrs Ida Mae Suttmoller, MA LCSW CASAC is a medicare enrolled "Social Worker - Clinical" provider in Versailles, Missouri. Her current practice location is
108 West Jasper, Versailles, Missouri. You can reach out to her office (for appointments etc.) via phone at
(573) 378-6833.
Mrs Ida Mae Suttmoller is licensed to practice in Missouri (license number 003970) 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 1912133323.
Healthcare Provider's Profile
Full Name | Mrs Ida Mae Suttmoller |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 108 West Jasper, Versailles, Missouri |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1912133323
- Provider Enumeration Date: 06/01/2009
- Last Update Date: 06/01/2009
Medicare PECOS Information:
- PECOS PAC ID: 2668379140
- Enrollment ID: I20031213000017
Medical Identifiers
Medical identifiers for Mrs Ida Mae Suttmoller such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1912133323 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 868 (Missouri) | Secondary |
1041C0700X | Social Worker - Clinical | 003970 (Missouri) | 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. Mrs Ida Mae Suttmoller allows following entities to bill medicare on her behalf.
Entity Name | Deer Oaks Mental Health Associates Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1134175763 PECOS PAC ID: 2264337013 Enrollment ID: O20040813000106 |
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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. Mrs Ida Mae Suttmoller 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 |
Mrs Ida Mae Suttmoller, MA LCSW CASAC 108 West Jasper, Versallies, MO 65084 Ph: (573) 378-6833 | Mrs Ida Mae Suttmoller, MA LCSW CASAC 108 West Jasper, Versailles, MO 65084 Ph: (573) 378-6833 |
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