Keeli Nicole Wagner, LICSW in Saint Paul, MN - Medicare Social Worker Provider

Keeli Nicole Wagner, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Saint Paul, Minnesota. Her current practice location is 640 Jackson St, Saint Paul, Minnesota. You can reach out to her office (for appointments etc.) via phone at (651) 254-1669.

Keeli Nicole Wagner is licensed to practice in Minnesota (license number 20422) 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 1598313058.

Contact Information

	Keeli Nicole Wagner, LICSW
	640 Jackson St, Saint Paul, MN 55101-2502
	(651) 254-1669
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Keeli Nicole Wagner
Gender	Female
Speciality	Social Worker - Clinical
Location	640 Jackson St, Saint Paul, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1598313058
Provider Enumeration Date: 08/28/2019
Last Update Date: 04/01/2025

Medicare PECOS Information:

PECOS PAC ID: 6305176645
Enrollment ID: I20190930000543

Medical Identifiers

Medical identifiers for Keeli Nicole Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1598313058	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	20422 (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. Keeli Nicole Wagner allows following entities to bill medicare on her behalf.

Entity Name	Group Health Plan Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1710924683 PECOS PAC ID: 1759293954 Enrollment ID: O20031105000417

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. Keeli Nicole Wagner 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
Keeli Nicole Wagner, LICSW 2530 Chicago Ave # Csc175, Minneapolis, MN 55404-4289 Ph: (612) 813-7411	Keeli Nicole Wagner, LICSW 640 Jackson St, Saint Paul, MN 55101-2502 Ph: (651) 254-1669

Reviews and Comments

Social Worker in Saint Paul, MN

Mr. Michael Joseph O'neill, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1919 University Ave W, Saint Paul, MN 55104 Phone: 651-266-7900 Fax: 651-266-7850
Ms. Sharon Kay Geiger, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1919 University Ave W, Saint Paul, MN 55104 Phone: 651-266-7978
Mrs. Karen Anne Stevensen, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2469 University Ave W, Saint Paul, MN 55114 Phone: 612-720-5083
Kathleen Lombardi, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1919 University Ave W Ste 200, Saint Paul, MN 55104 Phone: 651-266-7900
Ms. Sherie Lou Bosak, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 821 Raymond Ave, #300, Saint Paul, MN 55114 Phone: 651-645-0438 Fax: 651-647-0659
Helen Jane Gammon, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 640 Jackson St, Saint Paul, MN 55101 Phone: 651-254-2766
Ken Wilfred Schmitz, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2469 University Ave W, Saint Paul, MN 55114 Phone: 651-659-0294

Keeli Nicole Wagner, LICSW - Medicare Clinical Social Worker in Saint Paul, MN