Ms Pamela Jean Koonz, LCSW CSAC is a medicare enrolled "Social Worker" provider in Racine, Wisconsin. Her current practice location is
4810 Northwestern Ave, Racine, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(262) 637-9984.
Ms Pamela Jean Koonz is licensed to practice in Wisconsin (license number 3908123) 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 1518006667.
Healthcare Provider's Profile
| Full Name | Ms Pamela Jean Koonz |
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| Gender | Female |
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| Speciality | Social Worker |
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| Location | 4810 Northwestern Ave, Racine, 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: 1518006667
- Provider Enumeration Date: 02/05/2007
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 5597829127
- Enrollment ID: I20090127000349
Medical Identifiers
Medical identifiers for Ms Pamela Jean Koonz such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1518006667 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 1298132 (Wisconsin) | Primary |
| 104100000X | Social Worker | 3908123 (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. Ms Pamela Jean Koonz allows following entities to bill medicare on her behalf.
| Entity Name | Lakeside Family Therapy Services Ltd |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1407998719
PECOS PAC ID: 3678756400
Enrollment ID: O20110331000546 |
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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. Ms Pamela Jean Koonz 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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Ms Pamela Jean Koonz, LCSW CSAC
5329 Deerfield Rd,
Racine, WI 53406
Ph: () - | Ms Pamela Jean Koonz, LCSW CSAC
4810 Northwestern Ave,
Racine, WI 53406
Ph: (262) 637-9984 |
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