Staci Brandt, DPT is a medicare enrolled "Physical Therapist" provider in Gaylord, Minnesota. Her current practice location is
640 3rd St, Gaylord, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(507) 237-8730.
Staci Brandt is licensed to practice in Minnesota (license number 8577) 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 1750625265.
Healthcare Provider's Profile
| Full Name | Staci Brandt |
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| Gender | Female |
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| Speciality | Physical Therapist |
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| Location | 640 3rd St, Gaylord, Minnesota |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1750625265
- Provider Enumeration Date: 11/21/2012
- Last Update Date: 01/12/2023
Medicare PECOS Information:
- PECOS PAC ID: 2567833775
- Enrollment ID: I20230126002154
Medical Identifiers
Medical identifiers for Staci Brandt such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1750625265 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225100000X | Physical Therapist | 8577 (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. Staci Brandt allows following entities to bill medicare on her behalf.
| Provider Name | Powerback Rehabilitation Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1013498914
PECOS PAC ID: 2365359932
Enrollment ID: O20181204002105 |
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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. Staci Brandt 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 |
|---|
Staci Brandt, DPT
25605 361st Ave,
Henderson, MN 56044-3429
Ph: (507) 995-2289 | Staci Brandt, DPT
640 3rd St,
Gaylord, MN 55334-2297
Ph: (507) 237-8730 |
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