Jonathan James Mietchen, T-LMLP is a medicare enrolled "Clinical Neuropsychologist" provider in Madison, Wisconsin. His current practice location is
600 Highland Ave, Madison, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(608) 263-5430.
Jonathan James Mietchen is licensed to practice in Wisconsin (license number 3815-57) 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 1073030961.
Healthcare Provider's Profile
| Full Name | Jonathan James Mietchen |
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| Gender | Male |
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| Speciality | Clinical Neuropsychologist |
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| Location | 600 Highland Ave, Madison, Wisconsin |
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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: 1073030961
- Provider Enumeration Date: 08/23/2017
- Last Update Date: 02/08/2021
Medicare PECOS Information:
- PECOS PAC ID: 8325466527
- Enrollment ID: I20200921002295
Medical Identifiers
Medical identifiers for Jonathan James Mietchen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1073030961 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103TC0700X | Psychologist - Clinical | 2795 (Kansas) | Secondary |
| 103G00000X | Clinical Neuropsychologist | 3815-57 (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. Jonathan James Mietchen allows following entities to bill medicare on his behalf.
| Entity Name | University Of Wisconsin Medical Foundation Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1598784555
PECOS PAC ID: 6608785464
Enrollment ID: O20031111000435 |
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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. Jonathan James Mietchen 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 |
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Jonathan James Mietchen, T-LMLP
7974 Uw Health Ct,
Middleton, WI 53562-5531
Ph: () - | Jonathan James Mietchen, T-LMLP
600 Highland Ave,
Madison, WI 53792-9469
Ph: (608) 263-5430 |
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