Tiffany Marie Boelk, APNP in Fond Du Lac, WI - Medicare Nurse Practitioner

Tiffany Marie Boelk, APNP is a medicare enrolled "Nurse Practitioner" in Fond Du Lac, Wisconsin. She graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Agnesian Healthcare Inc and her current practice location is 420 E Division St, Fond Du Lac, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 923-7400.

Tiffany Marie Boelk is licensed to practice in Wisconsin (license number 10905-33) 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 1700459690.

Contact Information

	Tiffany Marie Boelk, APNP
	420 E Division St, Fond Du Lac, WI 54935-4560
	(920) 923-7400
	Not Available

Map and Direction

Provider's Profile

Full Name	Tiffany Marie Boelk
Gender	Female
Speciality	Nurse Practitioner
Experience	4 Years
Location	420 E Division St, Fond Du Lac, Wisconsin
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Tiffany Marie Boelk graduated from nursing school in 2020

NPI Data:

NPI Number: 1700459690
Provider Enumeration Date: 07/20/2021
Last Update Date: 10/12/2021

Medicare PECOS Information:

PECOS PAC ID: 2668878349
Enrollment ID: I20210903000903

Medical Identifiers

Medical identifiers for Tiffany Marie Boelk such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1700459690	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	10905-33 (Wisconsin)	Secondary
363L00000X	Nurse Practitioner	10905-33 (Wisconsin)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
St Agnes Hospital	Fond du lac, WI	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Agnesian Healthcare Inc	1658289624	335

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. Tiffany Marie Boelk allows following entities to bill medicare on her behalf.

Entity Name	Agnesian Healthcare Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1346228541 PECOS PAC ID: 1658289624 Enrollment ID: O20031104000263

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. Tiffany Marie Boelk 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
Tiffany Marie Boelk, APNP N3087 Hickory Rd, Byron, WI 53006-1126 Ph: (920) 517-2207	Tiffany Marie Boelk, APNP 420 E Division St, Fond Du Lac, WI 54935-4560 Ph: (920) 923-7400

Reviews and Comments

Nurse Practitioner Nurses in Fond Du Lac, WI

Jeanette Roehl, APNP FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 210 Wisconsin American Dr, Fond Du Lac, WI 54937 Phone: 920-907-7000
Mary R Kelm, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-8230
Michelle Kehrmeyer, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 209-926-4197 Fax: 920-926-4197
Jessica L Habeck, DNP, APNP, FNP-BC Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 430 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-5020
Mrs. Jennifer Nicole Stephany, APNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-8200 Fax: 920-926-8907
Theresa J Baseley, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 210 Wisconsin American Dr, Fond Du Lac, WI 54937 Phone: 920-907-7000 Fax: 920-907-7012
Tammy Rae Karls, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-8495

Tiffany Marie Boelk, APNP - Medicare Nurse Practitioner in Fond Du Lac, WI