Matthew Allan Mickelson, in Deforest, WI - Medicare Nurse Practitioner

Matthew Allan Mickelson, is a medicare enrolled "Nurse Practitioner - Family" in Deforest, Wisconsin. His current practice location is 4200 Savannah Dr, Deforest, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (608) 417-3300.

Matthew Allan Mickelson is licensed to practice in Wisconsin (license number 13661-33) 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 1942907647.

Contact Information

	Matthew Allan Mickelson,
	4200 Savannah Dr, Deforest, WI 53532-2909
	(608) 417-3300
	Not Available

Map and Direction

Provider's Profile

Full Name	Matthew Allan Mickelson
Gender	Male
Speciality	Nurse Practitioner - Family
Location	4200 Savannah Dr, Deforest, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1942907647
Provider Enumeration Date: 02/13/2023
Last Update Date: 09/12/2023

Medicare PECOS Information:

PECOS PAC ID: 2668838087
Enrollment ID: I20230510000083

Medical Identifiers

Medical identifiers for Matthew Allan Mickelson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1942907647	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	241314 (Wisconsin)	Secondary
363LF0000X	Nurse Practitioner - Family	13661-33 (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. Matthew Allan Mickelson allows following entities to bill medicare on his behalf.

Entity Name	Meriter Hospital Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1548280225 PECOS PAC ID: 3971412735 Enrollment ID: O20031126000346

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. Matthew Allan Mickelson 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
Matthew Allan Mickelson, 202 S Park St, Madison, WI 53715-1507 Ph: (608) 417-6000	Matthew Allan Mickelson, 4200 Savannah Dr, Deforest, WI 53532-2909 Ph: (608) 417-3300

Reviews and Comments

Nurse Practitioner Nurses in Deforest, WI

Kaylyn Bloyer, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 987 Griffin Way, Deforest, WI 53532 Phone: 608-768-6175
Catrina Heath, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4200 Savannah Dr, Deforest, WI 53532 Phone: 608-417-3300
Mrs. Tracy Lytle Huffstatler, APN, RN, ACNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4914 Innovation Dr, Deforest, WI 53532 Phone: 901-552-7885
Ms. Kathryn Marie Cacic, APNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 7752 Clinton Road, Deforest, WI 53532 Phone: 608-846-0614
Julie Lederman, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6648 Millstone Cir, Deforest, WI 53532 Phone: 608-842-0630

Matthew Allan Mickelson, - Medicare Nurse Practitioner in Deforest, WI