Wanda Sue Withington, OTR is a medicare enrolled "Occupational Therapist - Physical Rehabilitation" provider in Crystal, Minnesota. Her current practice location is
9000 Golden Valley Rd, Crystal, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(763) 543-9000.
Wanda Sue Withington is licensed to practice in Minnesota (license number 101181) 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 1992545974.
Healthcare Provider's Profile
Full Name | Wanda Sue Withington |
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Gender | Female |
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Speciality | Occupational Therapist - Physical Rehabilitation |
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Location | 9000 Golden Valley Rd, Crystal, Minnesota |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1992545974
- Provider Enumeration Date: 05/28/2024
- Last Update Date: 05/28/2024
Medicare PECOS Information:
- PECOS PAC ID: 8820532898
- Enrollment ID: I20240701003396
Medical Identifiers
Medical identifiers for Wanda Sue Withington such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1992545974 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225XP0019X | Occupational Therapist - Physical Rehabilitation | 101181 (Minnesota) | 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. Wanda Sue Withington allows following entities to bill medicare on her behalf.
Provider Name | Aegis Group Practice Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
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Provider Identifiers | NPI Number: 1417340126 PECOS PAC ID: 5193036432 Enrollment ID: O20150612001586 |
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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. Wanda Sue Withington 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 |
Wanda Sue Withington, OTR 9000 Golden Valley Rd, Golden Valley, MN 55427-4471 Ph: (763) 543-9000 | Wanda Sue Withington, OTR 9000 Golden Valley Rd, Crystal, MN 55427-4471 Ph: (763) 543-9000 |
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