Michele Leidholm, FNP is a medicare enrolled "Nurse Practitioner - Family" in Underwood, North Dakota. She graduated from nursing school in 1999 and has 25 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Underwood Clinic Pc and her current practice location is
87 Lincoln Ave, Underwood, North Dakota. You can reach out to her office (for appointments etc.) via phone at
(701) 442-3148.
Michele Leidholm is licensed to practice in North Dakota (license number R25469) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1417942335.
Provider's Profile
| Full Name | Michele Leidholm |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 25 Years |
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| Location | 87 Lincoln Ave, Underwood, North Dakota |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Michele Leidholm graduated from nursing school in 1999
NPI Data:
- NPI Number: 1417942335
- Provider Enumeration Date: 09/16/2005
- Last Update Date: 02/15/2008
Medicare PECOS Information:
- PECOS PAC ID: 3072426436
- Enrollment ID: I20031117000460
Medical Identifiers
Medical identifiers for Michele Leidholm such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1417942335 | NPI | - | NPPES |
| 19621 | Medicaid | ND | |
| A63211046001 | Other | | PREFERRED ONE |
| P00065098 | Other | | RR MEDICARE |
| 023494 | Other | ND | BCBS |
| 004 | Other | | AMERICA'S PPO |
| 025502 | Other | ND | BCBS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LF0000X | Nurse Practitioner - Family | R25469 (North Dakota) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Underwood Clinic Pc | 3678486156 | 4 |
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. Michele Leidholm allows following entities to bill medicare on her behalf.
| Entity Name | Underwood Clinic Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1770591927
PECOS PAC ID: 3678486156
Enrollment ID: O20031111000406 |
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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. Michele Leidholm 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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Michele Leidholm, FNP
Po Box 253,
Underwood, ND 58576-0253
Ph: (701) 442-3148 | Michele Leidholm, FNP
87 Lincoln Ave,
Underwood, ND 58576
Ph: (701) 442-3148 |
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