Tomas John Wildenborg, LICSW in Minneapolis, MN - Medicare Social Worker Provider

Tomas John Wildenborg, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Minneapolis, Minnesota. His current practice location is 2400 W 64th St, Minneapolis, Minnesota. You can reach out to his office (for appointments etc.) via phone at (612) 861-1688.

Tomas John Wildenborg is licensed to practice in Minnesota (license number 25741) 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 1023395282.

Contact Information

	Tomas John Wildenborg, LICSW
	2400 W 64th St, Minneapolis, MN 55423-1001
	(612) 861-1688
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Tomas John Wildenborg
Gender	Male
Speciality	Social Worker - Clinical
Location	2400 W 64th St, Minneapolis, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1023395282
Provider Enumeration Date: 11/15/2011
Last Update Date: 04/15/2021

Medicare PECOS Information:

PECOS PAC ID: 6305247339
Enrollment ID: I20210629001290

Medical Identifiers

Medical identifiers for Tomas John Wildenborg such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1023395282	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	25741 (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. Tomas John Wildenborg allows following entities to bill medicare on his behalf.

Entity Name	Fraser Child And Family Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1609922194 PECOS PAC ID: 3971918772 Enrollment ID: O20210208002399

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. Tomas John Wildenborg 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
Tomas John Wildenborg, LICSW 2400 W 64th St, Minneapolis, MN 55423-1001 Ph: (612) 861-1688	Tomas John Wildenborg, LICSW 2400 W 64th St, Minneapolis, MN 55423-1001 Ph: (612) 861-1688

Reviews and Comments

Social Worker in Minneapolis, MN

Mr. Tim D Sullivan, MSW, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 229 Ridgewood Ave, Apartment 112, Minneapolis, MN 55403 Phone: 612-600-7169
Catherine Elaine Schacher, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2525 Chicago Ave, Minneapolis, MN 55404 Phone: 612-813-6138
Don Coleman, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 2430 Nicollet Ave, Minneapolis, MN 55404 Phone: 612-871-1454 Fax: 612-871-1505
Nathan Foote, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1100 Glenwood Ave, Minneapolis, MN 55405 Phone: 612-871-1454 Fax: 612-871-1505
Seare Shibeshi, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2327 E Franklin Ave Ste 3, Minneapolis, MN 55406 Phone: 612-332-9124
Alex Jacob Hoyt, MSW, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 4027 County Road 25, Minneapolis, MN 55416 Phone: 612-925-6033 Fax: 612-925-8496
Elissa J Allen, LGSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 2925 Chicago Ave, Minneapolis, MN 55407 Phone: 866-603-0016

Tomas John Wildenborg, LICSW - Medicare Clinical Social Worker in Minneapolis, MN