Carly Dassow, APNP in Waunakee, WI - Medicare Nurse Practitioner

Carly Dassow, APNP is a medicare enrolled "Nurse Practitioner" in Waunakee, Wisconsin. Her current practice location is 1300 S Century Ave, Waunakee, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (608) 849-4315.

Carly Dassow is licensed to practice in Wisconsin (license number 14180) 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 1245668433.

Contact Information

	Carly Dassow, APNP
	1300 S Century Ave, Waunakee, WI 53597-2386
	(608) 849-4315
	(608) 850-1606

Map and Direction

Provider's Profile

Full Name	Carly Dassow
Gender	Female
Speciality	Nurse Practitioner
Location	1300 S Century Ave, Waunakee, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1245668433
Provider Enumeration Date: 10/24/2013
Last Update Date: 08/30/2023

Medicare PECOS Information:

PECOS PAC ID: 6901260660
Enrollment ID: I20230913002567

Medical Identifiers

Medical identifiers for Carly Dassow such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1245668433	NPI	-	NPPES
1245668433	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	14180 (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. Carly Dassow allows following entities to bill medicare on her behalf.

Entity Name	Dean Health Systems Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1053358846 PECOS PAC ID: 7012827983 Enrollment ID: O20031105000584

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. Carly Dassow 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
Carly Dassow, APNP 1300 S Century Ave, Waunakee, WI 53597-2386 Ph: (608) 849-4315	Carly Dassow, APNP 1300 S Century Ave, Waunakee, WI 53597-2386 Ph: (608) 849-4315

Reviews and Comments

Nurse Practitioner Nurses in Waunakee, WI

Dr. Erin Elizabeth Macmillan, CPNP-PC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1241 Dartmouth Dr, Waunakee, WI 53597 Phone: 608-850-9419
Suzanne J Dynneson, APNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1300 S Century Ave, Waunakee, WI 53597 Phone: 608-849-4315 Fax: 608-850-1606
Miss Kelly M Wisch, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1300 S Century Ave, Waunakee, WI 53597 Phone: 608-849-4315 Fax: 608-850-1606
Cory Sieburg, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 815 Victor Ln, Waunakee, WI 53597 Phone: 608-393-2685
Christine M Disch, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1300 S Century Ave, Waunakee, WI 53597 Phone: 608-849-4315 Fax: 608-850-1606
Teresa C Patwell, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1300 S Century Ave, Waunakee, WI 53597 Phone: 608-849-4315 Fax: 608-850-1606

Carly Dassow, APNP - Medicare Nurse Practitioner in Waunakee, WI