Brian A Wolf, PHD in Kenosha, WI - Medicare Psychologist Provider

Brian A Wolf, PHD is a medicare enrolled "Psychologist - Clinical" provider in Kenosha, Wisconsin. His current practice location is 2108 63rd St, Kenosha, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (262) 652-2406.

Brian A Wolf is licensed to practice in Wisconsin (license number 1039-057) 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 1609982040.

Contact Information

	Brian A Wolf, PHD
	2108 63rd St, Kenosha, WI 53143-4454
	(262) 652-2406
	(262) 652-2408

Map and Direction

Healthcare Provider's Profile

Full Name	Brian A Wolf
Gender	Male
Speciality	Psychologist - Clinical
Location	2108 63rd St, Kenosha, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1609982040
Provider Enumeration Date: 08/21/2006
Last Update Date: 06/30/2008

Medicare PECOS Information:

PECOS PAC ID: 8426216680
Enrollment ID: I20120521000466

Medical Identifiers

Medical identifiers for Brian A Wolf such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1609982040	NPI	-	NPPES
39046000	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	1039-057 (Wisconsin)	Primary
101YA0400X	Counselor - Addiction (substance Use Disorder)	12126 (Wisconsin)	Secondary

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. Brian A Wolf allows following entities to bill medicare on his behalf.

Entity Name	Professional Services Group Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1619024262 PECOS PAC ID: 8224296454 Enrollment ID: O20120220000742

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. Brian A Wolf 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
Brian A Wolf, PHD 6233 39th Ave, Kenosha, WI 53142-7015 Ph: (262) 654-1004	Brian A Wolf, PHD 2108 63rd St, Kenosha, WI 53143-4454 Ph: (262) 652-2406

Reviews and Comments

Psychologist in Kenosha, WI

Melissa A Wingate, PSYD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 10400 75th St, Kenosha, WI 53142 Phone: 262-948-7815 Fax: 262-948-7816
Dr. Michael Matthew Mihajlovic, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4536 22nd Ave, Kenosha, WI 53140 Phone: 262-656-0044 Fax: 262-653-2218
Dr. Katherine M Flynn, PSY.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 12225 71st St, Kenosha, WI 53142 Phone: 262-948-4780
Danielle Defreese, PSYD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 10400 75th St, Kenosha, WI 53142 Phone: 262-948-6839
David T Marx, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4536 22nd Ave, Kenosha, WI 53140 Phone: 262-656-0044 Fax: 262-653-2218
Debra Johansen, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 6121 Green Bay Rd, Suite 230, Kenosha, WI 53142 Phone: 262-654-8366
Dr. Kristin Marie Keeler, PSY.D Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5024 Green Bay Rd, Suite 120, Kenosha, WI 53144 Phone: 262-652-2365 Fax: 262-652-2071

Brian A Wolf, PHD - Medicare Psychologist in Kenosha, WI