Mrs Nichole M Elmendorf, OTR in Sheboygan, WI - Medicare Occupational Therapist Provider

Mrs Nichole M Elmendorf, OTR is a medicare enrolled "Occupational Therapist - Pediatrics" provider in Sheboygan, Wisconsin. Her current practice location is 1125 N 13th St, Sheboygan, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 803-1617.

Mrs Nichole M Elmendorf is licensed to practice in Wisconsin (license number 2461) 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 1255519443.

Contact Information

	Mrs Nichole M Elmendorf, OTR
	1125 N 13th St, Sheboygan, WI 53081-3281
	(920) 803-1617
	(920) 803-1622

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Nichole M Elmendorf
Gender	Female
Speciality	Occupational Therapist - Pediatrics
Location	1125 N 13th St, Sheboygan, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1255519443
Provider Enumeration Date: 02/10/2008
Last Update Date: 10/10/2022

Medicare PECOS Information:

PECOS PAC ID: 8022281864
Enrollment ID: I20141229000314

Medical Identifiers

Medical identifiers for Mrs Nichole M Elmendorf such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1255519443	NPI	-	NPPES
40806400	Medicaid	WI
41813000	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225XP0200X	Occupational Therapist - Pediatrics	2461 (Wisconsin)	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. Mrs Nichole M Elmendorf allows following entities to bill medicare on her behalf.

Provider Name	Progressive Beginnings, Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1598886152 PECOS PAC ID: 7012189848 Enrollment ID: O20141208001324

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. Mrs Nichole M Elmendorf 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
Mrs Nichole M Elmendorf, OTR 1125 N 13th St, Sheboygan, WI 53081-3281 Ph: (920) 803-1617	Mrs Nichole M Elmendorf, OTR 1125 N 13th St, Sheboygan, WI 53081-3281 Ph: (920) 803-1617

Reviews and Comments

Occupational Therapist in Sheboygan, WI

Emily Joann Lucht, M.S. OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3613 S 13th St, Sheboygan, WI 53081 Phone: 715-572-5893
Joshua R Luna, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2131 S Business Dr, Sheboygan, WI 53081 Phone: 920-803-1617 Fax: 920-803-1622
Hailey Witthun, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1125 N 13th St, Sheboygan, WI 53081 Phone: 920-803-1617
Ashley L Coop, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2508 Cooper Ave, Sheboygan, WI 53083 Phone: 920-838-4595
Mrs. Ann M Hering, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1125 N 13th St, Sheboygan, WI 53081 Phone: 920-208-9648
Mrs. Amy Kate Summers, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2629 N 7th St, Sheboygan, WI 53083 Phone: 920-451-5550
Sarah M Keller, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1125 N 13th St, Sheboygan, WI 53081 Phone: 920-208-9648 Fax: 920-208-6316

Mrs Nichole M Elmendorf, OTR - Medicare Occupational Therapist in Sheboygan, WI