Tracy Dierksen, MSW, LCSW, PLADC, RN is a medicare enrolled "Social Worker - Clinical" in Hay Springs, Nebraska. Her current practice location is
226 S Gibson St, Hay Springs, Nebraska. You can reach out to her office (for appointments etc.) via phone at
(308) 638-4411.
Tracy Dierksen is licensed to practice in Nebraska (license number 1456, 4091) 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 1689972325.
Provider's Profile
| Full Name | Tracy Dierksen |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 226 S Gibson St, Hay Springs, Nebraska |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1689972325
- Provider Enumeration Date: 03/04/2011
- Last Update Date: 10/28/2012
Medicare PECOS Information:
- PECOS PAC ID: 7719132810
- Enrollment ID: I20210915003695
Medical Identifiers
Medical identifiers for Tracy Dierksen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1689972325 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163W00000X | Registered Nurse | 53412 (Nebraska) | Secondary |
| 1041C0700X | Social Worker - Clinical | 1456, 4091 (Nebraska) | Primary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | P-1077 (Nebraska) | Secondary |
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. Tracy Dierksen allows following entities to bill medicare on her behalf.
| Entity Name | The Memorial Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1063418424
PECOS PAC ID: 1254231533
Enrollment ID: O20040112000299 |
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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. Tracy Dierksen 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 |
|---|
Tracy Dierksen, MSW, LCSW, PLADC, RN
226 S Gibson St, Po Box 86,
Hay Springs, NE 69347-4208
Ph: (308) 638-4411 | Tracy Dierksen, MSW, LCSW, PLADC, RN
226 S Gibson St,
Hay Springs, NE 69347-4208
Ph: (308) 638-4411 |
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