Edward Ericksen, in Bloomington, IL - Medicare Physical Therapist Provider

Edward Ericksen, is a medicare enrolled "Physical Therapist" provider in Bloomington, Illinois. His current practice location is 1111 Trinity Ln Ste 111, Bloomington, Illinois. You can reach out to his office (for appointments etc.) via phone at (309) 663-6461.

Edward Ericksen is licensed to practice in Illinois (license number 070027646) 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 1043610199.

Contact Information

	Edward Ericksen,
	1111 Trinity Ln Ste 111, Bloomington, IL 61704-8112
	(309) 663-6461
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Edward Ericksen
Gender	Male
Speciality	Physical Therapist
Location	1111 Trinity Ln Ste 111, Bloomington, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1043610199
Provider Enumeration Date: 08/26/2014
Last Update Date: 02/20/2024

Medicare PECOS Information:

PECOS PAC ID: 1153543269
Enrollment ID: I20240222002216

Medical Identifiers

Medical identifiers for Edward Ericksen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1043610199	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	PT.014702 (Ohio)	Secondary
225100000X	Physical Therapist	13706 (Wisconsin)	Secondary
225100000X	Physical Therapist	070027646 (Illinois)	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. Edward Ericksen allows following entities to bill medicare on his behalf.

Provider Name	Carle West Physician Group Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1467074138 PECOS PAC ID: 8921420308 Enrollment ID: O20200613000147

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. Edward Ericksen 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
Edward Ericksen, 611 W Park St, Fapc, Urbana, IL 61801-2500 Ph: () -	Edward Ericksen, 1111 Trinity Ln Ste 111, Bloomington, IL 61704-8112 Ph: (309) 663-6461

Reviews and Comments

Physical Therapist in Bloomington, IL

Ms. Mary Claire Biles, PT, MDT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1701 E College Ave, Bloomington, IL 61704 Phone: 309-664-3420 Fax: 309-664-3422
Mrs. Patricia O'meara, MPT, NDT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1701 E College Ave, Bloomington, IL 61704 Phone: 309-664-3420 Fax: 309-664-3422
Christopher Scot Byers, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 135 N Williamsburg Dr, Bloomington, IL 61704 Phone: 309-661-8823
Ms. Gretchen Dean, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1701 E College Ave, Bloomington, IL 61704 Phone: 217-326-2911 Fax: 217-344-8047
Dr. Alissa Recker, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1111 Trinity Ln, Suite 111, Bloomington, IL 61704 Phone: 309-663-6461 Fax: 309-661-8107
Ms. Abby L Curtis, PT, MS, CLT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1111 Trinity Lane, Suite 111, Bloomington, IL 61704 Phone: 309-663-6461 Fax: 309-661-8107

Edward Ericksen, - Medicare Physical Therapist in Bloomington, IL