Brooke Wigen, OTD is a medicare enrolled "Occupational Therapist" provider in Spirit Lake, Iowa. Her current practice location is
1819 23rd St, Spirit Lake, Iowa. You can reach out to her office (for appointments etc.) via phone at
(712) 336-3553.
Brooke Wigen is licensed to practice in Iowa (license number 092475) 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 1710696679.
Healthcare Provider's Profile
| Full Name | Brooke Wigen |
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| Gender | Female |
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| Speciality | Occupational Therapist |
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| Location | 1819 23rd St, Spirit Lake, Iowa |
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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: 1710696679
- Provider Enumeration Date: 11/21/2022
- Last Update Date: 11/21/2022
Medicare PECOS Information:
- PECOS PAC ID: 4082084215
- Enrollment ID: I20230105000947
Medical Identifiers
Medical identifiers for Brooke Wigen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1710696679 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225X00000X | Occupational Therapist | 105713 (Minnesota) | Secondary |
| 225X00000X | Occupational Therapist | 092475 (Iowa) | 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. Brooke Wigen allows following entities to bill medicare on her behalf.
| Provider Name | Blue Stone Therapy Inc. |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1932797297
PECOS PAC ID: 1850707787
Enrollment ID: O20210301002214 |
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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. Brooke Wigen 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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Brooke Wigen, OTD
115 2nd Ave,
Jackson, MN 56143-1806
Ph: () - | Brooke Wigen, OTD
1819 23rd St,
Spirit Lake, IA 51360-7096
Ph: (712) 336-3553 |
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