Michelle Wise Gendusa, LICSW in Fayetteville, AR - Medicare Social Worker Provider

Michelle Wise Gendusa, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Fayetteville, Arkansas. Her current practice location is 3546 W Greystone Dr., Fayetteville, Arkansas. You can reach out to her office (for appointments etc.) via phone at (509) 434-6386.

Michelle Wise Gendusa is licensed to practice in Arkansas (license number 22926-C) 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 1598505513.

Contact Information

	Michelle Wise Gendusa, LICSW
	3546 W Greystone Dr., Fayetteville, AR 72764
	(509) 434-6386
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Michelle Wise Gendusa
Gender	Female
Speciality	Social Worker - Clinical
Location	3546 W Greystone Dr., Fayetteville, Arkansas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1598505513
Provider Enumeration Date: 05/28/2024
Last Update Date: 01/26/2025

Medicare PECOS Information:

PECOS PAC ID: 2163950023
Enrollment ID: I20250107001064

Medical Identifiers

Medical identifiers for Michelle Wise Gendusa such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1598505513	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	LW60479720 (Washington)	Secondary
1041C0700X	Social Worker - Clinical	22926-C (Arkansas)	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. Michelle Wise Gendusa allows following entities to bill medicare on her behalf.

Entity Name	Rooted Therapy And Wellness Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1811719040 PECOS PAC ID: 4880122746 Enrollment ID: O20250107000502

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. Michelle Wise Gendusa 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
Michelle Wise Gendusa, LICSW 3546 E Greystone Dr, Fayetteville, AR 72764-6860 Ph: (870) 230-0238	Michelle Wise Gendusa, LICSW 3546 W Greystone Dr., Fayetteville, AR 72764 Ph: (509) 434-6386

Reviews and Comments

Social Worker in Fayetteville, AR

Courtney Elaine Goodrum, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1 W Sunbridge Dr, Fayetteville, AR 72703 Phone: 479-443-5575
Ernestine Dickson, MSW, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 516 S East Ave, Fayetteville, AR 72701 Phone: 501-313-1033
Nancy Lou Webb, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 17 W. Sunbridge, Fayetteville, AR 72703 Phone: 479-725-5224 Fax: 479-750-8967
Carla E Williams, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 905 W Eden Cir, Fayetteville, AR 72701 Phone: 479-409-6167 Fax: 479-587-8703
Jordan Hughes, MSW, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2354 N Montana Ave, Fayetteville, AR 72704 Phone: 501-690-3633
Kerri Vollmer, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2592 N Gregg Ave, Suite 16, Fayetteville, AR 72703 Phone: 479-582-5565
Mary C Ferguson, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 60 W Sunbridge Dr, Fayetteville, AR 72703 Phone: 479-695-1240 Fax: 479-695-1242

Michelle Wise Gendusa, LICSW - Medicare Clinical Social Worker in Fayetteville, AR