Nicholas Van Walleghem, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Kansas City, Missouri. His current practice location is
1911 E 23rd St, Kansas City, Missouri. You can reach out to his office (for appointments etc.) via phone at
(913) 706-1347.
Nicholas Van Walleghem is licensed to practice in Missouri (license number 2022001668) 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 1104406271.
Healthcare Provider's Profile
| Full Name | Nicholas Van Walleghem |
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| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 1911 E 23rd St, Kansas City, Missouri |
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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: 1104406271
- Provider Enumeration Date: 04/12/2021
- Last Update Date: 08/08/2022
Medicare PECOS Information:
- PECOS PAC ID: 1951783208
- Enrollment ID: I20220802003860
Medical Identifiers
Medical identifiers for Nicholas Van Walleghem such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1104406271 | NPI | - | NPPES |
| 490096849 | Medicaid | MO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | 2019026772 (Missouri) | Secondary |
| 1041C0700X | Social Worker - Clinical | 2022001668 (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. Nicholas Van Walleghem allows following entities to bill medicare on his behalf.
| Entity Name | A Balanced Life, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1518442698
PECOS PAC ID: 3173865326
Enrollment ID: O20190508002380 |
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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. Nicholas Van Walleghem 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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Nicholas Van Walleghem, LCSW
1911 E 23rd St,
Kansas City, MO 64127-3701
Ph: (816) 241-3448 | Nicholas Van Walleghem, LCSW
1911 E 23rd St,
Kansas City, MO 64127-3701
Ph: (913) 706-1347 |
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