Konnie Sue Luczak, RD, LD in Woodbury, MN - Medicare Dietitian, Registered Provider

Konnie Sue Luczak, RD, LD is a medicare enrolled "Dietitian, Registered" provider in Woodbury, Minnesota. Her current practice location is 237 Radio Dr Ste 210, Woodbury, Minnesota. You can reach out to her office (for appointments etc.) via phone at (612) 871-1145.

Konnie Sue Luczak is licensed to practice in Minnesota (license number 3245) 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 1114359205.

Contact Information

	Konnie Sue Luczak, RD, LD
	237 Radio Dr Ste 210, Woodbury, MN 55125-4478
	(612) 871-1145
	(612) 870-5491

Map and Direction

Healthcare Provider's Profile

Full Name	Konnie Sue Luczak
Gender	Female
Speciality	Dietitian, Registered
Location	237 Radio Dr Ste 210, Woodbury, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1114359205
Provider Enumeration Date: 07/31/2013
Last Update Date: 04/05/2022

Medicare PECOS Information:

PECOS PAC ID: 4082858782
Enrollment ID: I20130919000412

Medical Identifiers

Medical identifiers for Konnie Sue Luczak such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114359205	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
133V00000X	Dietitian, Registered	3245 (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. Konnie Sue Luczak allows following entities to bill medicare on her behalf.

Provider Name	Mngi Digestive Health Pa
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1609804541 PECOS PAC ID: 8123016557 Enrollment ID: O20040504001467

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. Konnie Sue Luczak 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
Konnie Sue Luczak, RD, LD 1900 Centracare Cir, Centracare Clinic Health Plaza, Saint Cloud, MN 56303-5000 Ph: (320) 229-4916	Konnie Sue Luczak, RD, LD 237 Radio Dr Ste 210, Woodbury, MN 55125-4478 Ph: (612) 871-1145

Reviews and Comments

Dietitian, Registered in Woodbury, MN

Abby Marie Olson, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 680 Commerce Dr Ste 260, Woodbury, MN 55125 Phone: 651-207-7197 Fax: 877-992-0282
Abbie Nichole Scott, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 576 Bielenberg Dr, Suite 250, Woodbury, MN 55125 Phone: 651-645-5323 Fax: 651-348-3355
Ms. Valerie Loftus, RD, LD Dietitian Medicare: Accepting Medicare Assignments Practice Location: 8450 Seasons Pkwy, Woodbury, MN 55125 Phone: 651-702-5300 Fax: 651-702-5305
Claire Rustad Welo, PA-C Dietitian Medicare: Medicare Enrolled Practice Location: 576 Bielenberg Dr Ste 250, Woodbury, MN 55125 Phone: 866-821-0281
Kayla R Mcclanahan, RDN, LD, CNSC Dietitian Medicare: Medicare Enrolled Practice Location: 1875 Woodwinds Dr, Woodbury, MN 55125 Phone: 651-232-6800 Fax: 651-232-6802
Dana Cizinski, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 8450 Seasons Pkwy, Woodbury, MN 55125 Phone: 651-702-5300

Konnie Sue Luczak, RD, LD - Medicare Dietitian in Woodbury, MN