Shanna Rose Thomsen, is a medicare enrolled "Psychologist - Clinical" provider in Milwaukee, Wisconsin. Her current practice location is
9205 W Center St Ste 200, Milwaukee, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(414) 279-9082.
Shanna Rose Thomsen is licensed to practice in Wisconsin (license number 3972-57) 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 1417438250.
Healthcare Provider's Profile
Full Name | Shanna Rose Thomsen |
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Gender | Female |
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Speciality | Psychologist - Clinical |
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Location | 9205 W Center St Ste 200, Milwaukee, 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: 1417438250
- Provider Enumeration Date: 08/28/2018
- Last Update Date: 06/05/2023
Medicare PECOS Information:
- PECOS PAC ID: 6204232531
- Enrollment ID: I20210910002168
Medical Identifiers
Medical identifiers for Shanna Rose Thomsen such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1417438250 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
103TC0700X | Psychologist - Clinical | 3972-57 (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. Shanna Rose Thomsen allows following entities to bill medicare on her behalf.
Entity Name | Professional Services Group Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1619024262 PECOS PAC ID: 8224296454 Enrollment ID: O20120220000742 |
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Entity Name | Intentional Psychology Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1699469411 PECOS PAC ID: 7416315247 Enrollment ID: O20230626002994 |
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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. Shanna Rose Thomsen 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 |
Shanna Rose Thomsen, 9205 W Center St Ste 200, Milwaukee, WI 53222-4548 Ph: (414) 279-9082 | Shanna Rose Thomsen, 9205 W Center St Ste 200, Milwaukee, WI 53222-4548 Ph: (414) 279-9082 |
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