Susan Rose Gran, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Duluth, Minnesota. Her current practice location is
502 E 2nd St, Duluth, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(218) 722-4379.
Susan Rose Gran is licensed to practice in Minnesota (license number 23873) 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 1669812319.
Healthcare Provider's Profile
| Full Name | Susan Rose Gran |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 502 E 2nd St, Duluth, Minnesota |
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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: 1669812319
- Provider Enumeration Date: 06/26/2013
- Last Update Date: 11/23/2022
Medicare PECOS Information:
- PECOS PAC ID: 6406117266
- Enrollment ID: I20180219002697
Medical Identifiers
Medical identifiers for Susan Rose Gran such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1669812319 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 23873 (Minnesota) | 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. Susan Rose Gran allows following entities to bill medicare on her behalf.
| Entity Name | The Duluth Clinic Ltd |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1902563638
PECOS PAC ID: 2567374283
Enrollment ID: O20031103000229 |
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| Entity Name | Nystrom & Associates Ltd |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1396750188
PECOS PAC ID: 6406752492
Enrollment ID: O20031210000592 |
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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. Susan Rose Gran 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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Susan Rose Gran, LICSW
400 E 3rd St,
Duluth, MN 55805-1951
Ph: (218) 786-8364 | Susan Rose Gran, LICSW
502 E 2nd St,
Duluth, MN 55805-1913
Ph: (218) 722-4379 |
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