Tim Johnson, MSW, LICSW & LMFT is a medicare enrolled "Marriage & Family Therapist" provider in Lake Elmo, Minnesota. His current practice location is
8669 Eagle Point Blvd, Lake Elmo, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(651) 379-0444.
Tim Johnson is licensed to practice in Minnesota (license number 157) 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 1154310126.
Healthcare Provider's Profile
| Full Name | Tim Johnson |
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| Gender | Male |
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| Speciality | Marriage & Family Therapist |
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| Location | 8669 Eagle Point Blvd, Lake Elmo, Minnesota |
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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: 1154310126
- Provider Enumeration Date: 10/20/2005
- Last Update Date: 12/23/2011
Medicare PECOS Information:
- PECOS PAC ID: 0446488118
- Enrollment ID: I20140103000027
Medical Identifiers
Medical identifiers for Tim Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1154310126 | NPI | - | NPPES |
| 563T1JO | Other | MN | BCBS ID# |
| 62-13403 | Other | MN | MEDICA/UBH ID# |
| 247927 | Other | MN | COMPSYCH |
| O95457000 | Other | | MAGELLAN/AETNA |
| 181557200 | Medicaid | MN | |
| 69599 | Other | MN | VALUE OPTIONS ID# |
| 102218 | Other | | BHP/FAIRVIEW ID# |
| HP45669 | Other | MN | HEALTH PARTNERS ID# |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1041C0700X | Social Worker - Clinical | 409 (Minnesota) | Secondary |
| 106H00000X | Marriage & Family Therapist | 157 (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. Tim Johnson allows following entities to bill medicare on his behalf.
| Entity Name | Bachmann And Associates Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1538158506
PECOS PAC ID: 0749271781
Enrollment ID: O20040519001173 |
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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. Tim Johnson 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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Tim Johnson, MSW, LICSW & LMFT
8669 Eagle Point Blvd,
Lake Elmo, MN 55042-8628
Ph: (651) 379-0444 | Tim Johnson, MSW, LICSW & LMFT
8669 Eagle Point Blvd,
Lake Elmo, MN 55042-8628
Ph: (651) 379-0444 |
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