Shannon Marie Coulter, PT in Hartford, WI - Medicare Physical Therapist Provider

Shannon Marie Coulter, PT is a medicare enrolled "Physical Therapist" provider in Hartford, Wisconsin. Her current practice location is 1032 E Sumner St, Hartford, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (262) 670-4300.

Shannon Marie Coulter is licensed to practice in Wisconsin (license number 4005-024) 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 1134338890.

Contact Information

	Shannon Marie Coulter, PT
	1032 E Sumner St, Hartford, WI 53027-1608
	(262) 670-4300
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Shannon Marie Coulter
Gender	Female
Speciality	Physical Therapist
Location	1032 E Sumner St, Hartford, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1134338890
Provider Enumeration Date: 05/21/2007
Last Update Date: 12/08/2021

Medicare PECOS Information:

PECOS PAC ID: 7517399173
Enrollment ID: I20191120000524

Medical Identifiers

Medical identifiers for Shannon Marie Coulter such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1134338890	NPI	-	NPPES
36103500	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	4005-024 (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. Shannon Marie Coulter allows following entities to bill medicare on her behalf.

Provider Name	Aegis Group Practice Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1275073363 PECOS PAC ID: 5193036432 Enrollment ID: O20170614002978

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. Shannon Marie Coulter 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
Shannon Marie Coulter, PT 1032 E Sumner St, Hartford, WI 53027-1608 Ph: (262) 670-4300	Shannon Marie Coulter, PT 1032 E Sumner St, Hartford, WI 53027-1608 Ph: (262) 670-4300

Reviews and Comments

Physical Therapist in Hartford, WI

Aegis Group Practice Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1025 Bell Ave, Hartford, WI 53027 Phone: 800-444-6845 Fax: 479-478-2852
Jenna L Koeppel, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1032 E Sumner St, Hartford, WI 53027 Phone: 262-670-4300 Fax: 262-670-4303
Janet L Temmer, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1032 E Sumner St, Hartford, WI 53027 Phone: 262-670-7000
Gretchen Rakowski, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 110 Lone Oak Ln, Hartford, WI 53027 Phone: 262-836-6390 Fax: 262-836-6350
Kristine M Erickson, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1640 E Sumner St, Hartford, WI 53027 Phone: 262-670-7550
Tess Cederholm, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 110 Lone Oak Ln, Hartford, WI 53027 Phone: 262-670-1800

Shannon Marie Coulter, PT - Medicare Physical Therapist in Hartford, WI