Blake William Siersema, PT, DPT in Simpsonville, SC - Medicare Physical Therapist Provider

Blake William Siersema, PT, DPT is a medicare enrolled "Physical Therapist" provider in Simpsonville, South Carolina. His current practice location is 719 Se Main St Ste B, Simpsonville, South Carolina. You can reach out to his office (for appointments etc.) via phone at (864) 233-5128.

Blake William Siersema is licensed to practice in South Carolina (license number 11728) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1588361992.

Contact Information

	Blake William Siersema, PT, DPT
	719 Se Main St Ste B, Simpsonville, SC 29681-3237
	(864) 233-5128
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Blake William Siersema
Gender	Male
Speciality	Physical Therapist
Location	719 Se Main St Ste B, Simpsonville, South Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1588361992
Provider Enumeration Date: 02/15/2023
Last Update Date: 02/15/2023

Medicare PECOS Information:

PECOS PAC ID: 8820463151
Enrollment ID: I20230418002348

Medical Identifiers

Medical identifiers for Blake William Siersema such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1588361992	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	11728 (South Carolina)	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. Blake William Siersema allows following entities to bill medicare on his behalf.

Provider Name	Elite Integrated Therapy Centers Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1184673600 PECOS PAC ID: 3274552716 Enrollment ID: O20051115000119

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. Blake William Siersema 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
Blake William Siersema, PT, DPT 1007 Grove Rd Ste C, Greenville, SC 29605-4630 Ph: (864) 233-5128	Blake William Siersema, PT, DPT 719 Se Main St Ste B, Simpsonville, SC 29681-3237 Ph: (864) 233-5128

Reviews and Comments

Physical Therapist in Simpsonville, SC

Mrs. Melynda Kosmos, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6 Felhurst Ct, Simpsonville, SC 29681 Phone: 864-412-8900
Charlotte Walter, Physical Therapist Medicare: Medicare Enrolled Practice Location: 100 Allawood Ct # 110, Simpsonville, SC 29681 Phone: 864-525-2654
Rosario Gomez-ochoa, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 203 North Maple Street Ste10, Simpsonville, SC 29681 Phone: 864-757-9846 Fax: 864-757-9847
Erin Elizabeth Parmelee, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 817 Plantation Dr, Simpsonville, SC 29681 Phone: 864-238-2334
Katelyn Elizabeth Burn, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 300 Scuffletown Rd, Simpsonville, SC 29681 Phone: 864-329-8110
Holly Nichole Chittenden, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 727 Se Main St Ste 200, Simpsonville, SC 29681 Phone: 864-454-6670
Accelerated Physical Therapy Physical Therapist Medicare: Medicare Enrolled Practice Location: 883 Ne Main St, Simpsonville, SC 29681 Phone: 864-962-8016 Fax: 864-962-8116

Blake William Siersema, PT, DPT - Medicare Physical Therapist in Simpsonville, SC