Nicole Mazour, PT, DPT in Detroit Lakes, MN - Medicare Physical Therapist Provider

Nicole Mazour, PT, DPT is a medicare enrolled "Physical Therapist" provider in Detroit Lakes, Minnesota. Her current practice location is 1245 Washington Ave, Detroit Lakes, Minnesota. You can reach out to her office (for appointments etc.) via phone at (218) 846-2000.

Nicole Mazour is licensed to practice in Minnesota (license number 13305) 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 1003692427.

Contact Information

	Nicole Mazour, PT, DPT
	1245 Washington Ave, Detroit Lakes, MN 56501-3923
	(218) 846-2000
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Nicole Mazour
Gender	Female
Speciality	Physical Therapist
Location	1245 Washington Ave, Detroit Lakes, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1003692427
Provider Enumeration Date: 09/01/2023
Last Update Date: 06/11/2024

Medicare PECOS Information:

PECOS PAC ID: 8628422219
Enrollment ID: I20231002000366

Medical Identifiers

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

Identifier	Type	State	Issuer
1003692427	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	2746 (North Dakota)	Secondary
225100000X	Physical Therapist	13305 (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. Nicole Mazour allows following entities to bill medicare on her behalf.

Provider Name	Total Balance Physical Therapy And Fitness Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1588175061 PECOS PAC ID: 8820356991 Enrollment ID: O20200915002028

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 Mazour 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 Mazour, PT, DPT Po Box 5074, Sioux Falls, SD 57117-5074 Ph: (605) 328-9419	Nicole Mazour, PT, DPT 1245 Washington Ave, Detroit Lakes, MN 56501-3923 Ph: (218) 846-2000

Reviews and Comments

Physical Therapist in Detroit Lakes, MN

Kelsey Wilberg, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1027 Washington Ave, Detroit Lakes, MN 56501 Phone: 218-847-5611
Monica Kemper, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1027 Washington Ave, Detroit Lakes, MN 56501 Phone: 218-847-5611
Beth Sternhagen, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1027 Washington Ave, Detroit Lakes, MN 56501 Phone: 218-847-5611
Leah R Pettit, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1027 Washington Ave, Detroit Lakes, MN 56501 Phone: 218-844-2300
Patricia Marie Stalberger, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1415 Madison Ave, Detroit Lakes, MN 56501 Phone: 218-844-7119
Heather A Kiebke, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1245 Washington Ave, Detroit Lakes, MN 56501 Phone: 218-846-2000

Nicole Mazour, PT, DPT - Medicare Physical Therapist in Detroit Lakes, MN