Nicole Marie Chisholm, OTR/L in Hudson, WI - Medicare Occupational Therapist Provider

Nicole Marie Chisholm, OTR/L is a medicare enrolled "Occupational Therapist - Pediatrics" provider in Hudson, Wisconsin. Her current practice location is 2705 Enloe St, Hudson, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (715) 690-2600.

Nicole Marie Chisholm is licensed to practice in Wisconsin (license number 6936-26) 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 1013592542.

Contact Information

	Nicole Marie Chisholm, OTR/L
	2705 Enloe St, Hudson, WI 54016-8173
	(715) 690-2600
	(715) 381-8131

Map and Direction

Healthcare Provider's Profile

Full Name	Nicole Marie Chisholm
Gender	Female
Speciality	Occupational Therapist - Pediatrics
Location	2705 Enloe St, Hudson, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1013592542
Provider Enumeration Date: 03/16/2021
Last Update Date: 01/18/2022

Medicare PECOS Information:

PECOS PAC ID: 2961810510
Enrollment ID: I20210809003052

Medical Identifiers

Medical identifiers for Nicole Marie Chisholm such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1013592542	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225XP0200X	Occupational Therapist - Pediatrics	6936-26 (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. Nicole Marie Chisholm allows following entities to bill medicare on her behalf.

Provider Name	Family Speech & Therapy Services Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1235285966 PECOS PAC ID: 8022335397 Enrollment ID: O20150325001650

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. Nicole Marie Chisholm 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
Nicole Marie Chisholm, OTR/L 2705 Enloe St, Hudson, WI 54016-8173 Ph: (715) 690-2600	Nicole Marie Chisholm, OTR/L 2705 Enloe St, Hudson, WI 54016-8173 Ph: (715) 690-2600

Reviews and Comments

Occupational Therapist in Hudson, WI

Caroline Kay Williamson, OTR L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2705 Enloe St, Hudson, WI 54016 Phone: 715-386-2128
Jennifer Marie Cook, BSW, MA OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 742 Sterbenz Dr, St Croix Therapy Inc, Hudson, WI 54016 Phone: 715-386-2128 Fax: 715-386-6119
Caroline Mccleary, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 742 Sterbenz Dr, Hudson, WI 54016 Phone: 715-386-2128
Alecia Lyn Dadez, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 742 Sterbenz Dr, Hudson, WI 54016 Phone: 715-386-2128
Malorie Morgan Richer, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 2705 Enloe St, Hudson, WI 54016 Phone: 715-690-2600
Heather May Simmel, MOTR/L, CLT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 405 Stageline Rd, Hudson, WI 54016 Phone: 715-531-6321

Nicole Marie Chisholm, OTR/L - Medicare Occupational Therapist in Hudson, WI