Ms Mary J Crockett, OTRL in Superior, WI - Medicare Occupational Therapist Provider

Ms Mary J Crockett, OTRL is a medicare enrolled "Occupational Therapist" provider in Superior, Wisconsin. Her current practice location is 1800 New York Ave, Superior, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (715) 394-5591.

Ms Mary J Crockett is licensed to practice in Wisconsin (license number 4163026) 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 1417160169.

Contact Information

	Ms Mary J Crockett, OTRL
	1800 New York Ave, Superior, WI 54880
	(715) 394-5591
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Ms Mary J Crockett
Gender	Female
Speciality	Occupational Therapist
Location	1800 New York Ave, Superior, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1417160169
Provider Enumeration Date: 05/08/2007
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 7719104892
Enrollment ID: I20140813002070

Medical Identifiers

Medical identifiers for Ms Mary J Crockett such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1417160169	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225X00000X	Occupational Therapist	4163026 (Wisconsin)	Primary
225X00000X	Occupational Therapist	101276 (Minnesota)	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. Ms Mary J Crockett allows following entities to bill medicare on her behalf.

Provider Name	Avera Marshall
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1568401016 PECOS PAC ID: 5799695227 Enrollment ID: O20031106000219

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. Ms Mary J Crockett 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
Ms Mary J Crockett, OTRL 21 Green Lane, Silver Bay, MN 55614-1235 Ph: (218) 226-0194	Ms Mary J Crockett, OTRL 1800 New York Ave, Superior, WI 54880 Ph: (715) 394-5591

Reviews and Comments

Occupational Therapist in Superior, WI

Allison N Kostreba, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 35 N 28th St, Superior, WI 54880 Phone: 763-219-5521
Anastasia Pitzen, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1915 N 34th St, Superior, WI 54880 Phone: 715-399-3287
Brenda Christine Baker, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3500 Tower Ave, Superior, WI 54880 Phone: 715-395-5454
Lonni Marie Brickson, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3500 Tower Ave, Superior, WI 54880 Phone: 715-395-5454
Paula Bjoralt, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 39 N 25th St E, Superior, WI 54880 Phone: 763-689-5385 Fax: 763-689-5558
Kelsey Rubatt, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1612 N 37th St, Superior, WI 54880 Phone: 715-718-2101

Ms Mary J Crockett, OTRL - Medicare Occupational Therapist in Superior, WI