Lori Humphrey Haseloff, MOTR/L in Fort Worth, TX - Medicare Occupational Therapist Provider

Lori Humphrey Haseloff, MOTR/L is a medicare enrolled "Occupational Therapist" provider in Fort Worth, Texas. Her current practice location is 5417 Altamesa Blvd, Fort Worth, Texas. You can reach out to her office (for appointments etc.) via phone at (817) 370-6222.

Lori Humphrey Haseloff is licensed to practice in Texas (license number 113426) 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 1053691303.

Contact Information

	Lori Humphrey Haseloff, MOTR/L
	5417 Altamesa Blvd, Fort Worth, TX 76123-2804
	(817) 370-6222
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Lori Humphrey Haseloff
Gender	Female
Speciality	Occupational Therapist
Location	5417 Altamesa Blvd, Fort Worth, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1053691303
Provider Enumeration Date: 08/18/2011
Last Update Date: 06/04/2021

Medicare PECOS Information:

PECOS PAC ID: 3779983879
Enrollment ID: I20210610003114

Medical Identifiers

Medical identifiers for Lori Humphrey Haseloff such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1053691303	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225X00000X	Occupational Therapist	113426 (Texas)	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. Lori Humphrey Haseloff allows following entities to bill medicare on her behalf.

Provider Name	Legacy Healthcare Services Inc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1871132357 PECOS PAC ID: 2163339722 Enrollment ID: O20170201001261

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. Lori Humphrey Haseloff 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
Lori Humphrey Haseloff, MOTR/L 12116 Bella Palazzo Dr, Fort Worth, TX 76126-2134 Ph: (254) 717-8490	Lori Humphrey Haseloff, MOTR/L 5417 Altamesa Blvd, Fort Worth, TX 76123-2804 Ph: (817) 370-6222

Reviews and Comments

Occupational Therapist in Fort Worth, TX

Ms. Mary Cathrine Mckenzie, MOT/OTR, CPRCS Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 7217 Hawkins View Dr Ste 201, Fort Worth, TX 76132 Phone: 817-479-7019
Holly Christina Andrews, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 5316 Trail Lake Dr, Fort Worth, TX 76133 Phone: 817-292-8787 Fax: 817-789-6489
Mrs. Sue Khammar, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 4140 Tamworth Rd, Fort Worth, TX 76116 Phone: 817-386-5500 Fax: 817-386-5500
Danyelle Braelyn Huffaker, OTR Occupational Therapist Medicare: Medicare Enrolled Practice Location: 8000 Calmont Ave, Fort Worth, TX 76116 Phone: 817-400-2273
Lauren Elizabeth Galipp, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3840 Hulen St, Fort Worth, TX 76107 Phone: 817-335-3022
Katherine Moos, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 5300 Altamesa Blvd, Fort Worth, TX 76133 Phone: 817-346-1800
Diane R Alfino, O.T. Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2500 West Fwy, Suite 100, Fort Worth, TX 76102 Phone: 888-997-2669

Lori Humphrey Haseloff, MOTR/L - Medicare Occupational Therapist in Fort Worth, TX