Sarah Jane Petersen, LCSW is a medicare enrolled "Social Worker" provider in Beloit, Wisconsin. Her current practice location is
540 E Grand Ave, Beloit, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(608) 368-8087.
Sarah Jane Petersen is licensed to practice in * (Not Available) (license number ) 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 1073228607.
Healthcare Provider's Profile
Full Name | Sarah Jane Petersen |
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Gender | Female |
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Speciality | Social Worker |
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Location | 540 E Grand Ave, Beloit, Wisconsin |
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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: 1073228607
- Provider Enumeration Date: 01/18/2023
- Last Update Date: 05/01/2024
Medicare PECOS Information:
- PECOS PAC ID: 7719337542
- Enrollment ID: I20231220001260
Medical Identifiers
Medical identifiers for Sarah Jane Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1073228607 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
104100000X | Social Worker | (* (Not Available)) | 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. Sarah Jane Petersen allows following entities to bill medicare on her behalf.
Entity Name | Stateline Mental Health Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1538560255 PECOS PAC ID: 1658655865 Enrollment ID: O20170308001000 |
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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. Sarah Jane Petersen 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 |
Sarah Jane Petersen, LCSW 540 E Grand Ave, Beloit, WI 53511-6314 Ph: (608) 368-8087 | Sarah Jane Petersen, LCSW 540 E Grand Ave, Beloit, WI 53511-6314 Ph: (608) 368-8087 |
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