Tyler G Luedke, SAC is a medicare enrolled "Social Worker - Clinical" provider in Green Bay, Wisconsin. His current practice location is
3150 Gershwin Dr, Green Bay, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(920) 391-6964.
Tyler G Luedke is licensed to practice in Wisconsin (license number 10068-123) 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 1821431099.
Healthcare Provider's Profile
| Full Name | Tyler G Luedke |
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| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 3150 Gershwin Dr, Green Bay, 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: 1821431099
- Provider Enumeration Date: 04/08/2013
- Last Update Date: 10/25/2022
Medicare PECOS Information:
- PECOS PAC ID: 7618347212
- Enrollment ID: I20221222001567
Medical Identifiers
Medical identifiers for Tyler G Luedke such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1821431099 | NPI | - | NPPES |
| 1528098530 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 15877-131 (Wisconsin) | Secondary |
| 104100000X | Social Worker | 131735-121 (Wisconsin) | Secondary |
| 1041C0700X | Social Worker - Clinical | 10068-123 (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. Tyler G Luedke allows following entities to bill medicare on his behalf.
| Entity Name | County Of Brown |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1942305065
PECOS PAC ID: 1355435900
Enrollment ID: O20100524000844 |
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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. Tyler G Luedke 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 |
|---|
Tyler G Luedke, SAC
3150 Gershwin Dr,
Green Bay, WI 54311-4328
Ph: (920) 391-4740 | Tyler G Luedke, SAC
3150 Gershwin Dr,
Green Bay, WI 54311-4328
Ph: (920) 391-6964 |
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