Katelyn Ann Mickelson, in Fargo, ND - Medicare Psychologist Provider

Katelyn Ann Mickelson, is a medicare enrolled "Psychologist" provider in Fargo, North Dakota. Her current practice location is 100 4th St S, Fargo, North Dakota. You can reach out to her office (for appointments etc.) via phone at (701) 234-3100.

Katelyn Ann Mickelson is licensed to practice in North Dakota (license number 609P) 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 1427431279.

Contact Information

	Katelyn Ann Mickelson,
	100 4th St S, Fargo, ND 58103-1929
	(701) 234-3100
	(701) 234-3120

Map and Direction

Healthcare Provider's Profile

Full Name	Katelyn Ann Mickelson
Gender	Female
Speciality	Psychologist
Location	100 4th St S, Fargo, North Dakota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1427431279
Provider Enumeration Date: 06/29/2015
Last Update Date: 03/28/2022

Medicare PECOS Information:

PECOS PAC ID: 9335543719
Enrollment ID: I20210806001381

Medical Identifiers

Medical identifiers for Katelyn Ann Mickelson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1427431279	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	LP6215 (Minnesota)	Secondary
390200000X	Student In An Organized Health Care Education/training Program	(* (Not Available))	Secondary
103T00000X	Psychologist	609P (North Dakota)	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. Katelyn Ann Mickelson allows following entities to bill medicare on her behalf.

Entity Name	Sanford Medical Center Fargo
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1184917924 PECOS PAC ID: 8426967803 Enrollment ID: O20110331000495

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. Katelyn Ann Mickelson 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
Katelyn Ann Mickelson, Po Box 5074, Sioux Falls, SD 57117-5074 Ph: (605) 328-6585	Katelyn Ann Mickelson, 100 4th St S, Fargo, ND 58103-1929 Ph: (701) 234-3100

Reviews and Comments

Psychologist in Fargo, ND

Dr. Jaryn Lynn Allen, PH.D., LP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4733 Amber Valley Pkwy S Ste W, Fargo, ND 58104 Phone: 701-368-7400
Dr. Nicola Ashton Herting, PHD, LP Psychologist Medicare: Medicare Enrolled Practice Location: 100 4th St S Ste 302, Fargo, ND 58103 Phone: 701-234-4587
Ryan D Jagim, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 100 4th St S, Fargo, ND 58103 Phone: 701-234-4141 Fax: 701-234-4024
Dr. Sarah R. Edwards, LP, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 3309 Fiechtner Dr S Ste H, Fargo, ND 58103 Phone: 218-303-6164
Dr. Ani Celine Mangold, PHD, LP Psychologist Medicare: Medicare Enrolled Practice Location: 100 4th St S, Fargo, ND 58103 Phone: 701-234-2000
Ellee Bergren, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 700 7th St S, Fargo, ND 58103 Phone: 701-446-1014
Jay Robert Phillippi, PH.D. Psychologist Medicare: Medicare Enrolled Practice Location: 112 University Dr N Ste 300, Fargo, ND 58102 Phone: 701-866-3641 Fax: 701-660-1071

Katelyn Ann Mickelson, - Medicare Psychologist in Fargo, ND