Brian L Boomgarden, MS CADC in Manitowoc, WI - Medicare Counselor Provider

Brian L Boomgarden, MS CADC is a medicare enrolled "Counselor - Mental Health" provider in Manitowoc, Wisconsin. His current practice location is 339 Reed Ave, Manitowoc, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (920) 320-8600.

Brian L Boomgarden is licensed to practice in Wisconsin (license number 2898-123) 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 1871510677.

Contact Information

	Brian L Boomgarden, MS CADC
	339 Reed Ave, Manitowoc, WI 54220-2020
	(920) 320-8600
	(920) 320-8662

Map and Direction

Healthcare Provider's Profile

Full Name	Brian L Boomgarden
Gender	Male
Speciality	Counselor - Mental Health
Location	339 Reed Ave, Manitowoc, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1871510677
Provider Enumeration Date: 07/16/2006
Last Update Date: 06/03/2008

Medicare PECOS Information:

PECOS PAC ID: 1355784372
Enrollment ID: I20240207000779

Medical Identifiers

Medical identifiers for Brian L Boomgarden such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1871510677	NPI	-	NPPES
13647	Other		NETWORK HEALTH PLAN
39647200	Medicaid	WI
390806395	Other		CIGNA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YA0400X	Counselor - Addiction (substance Use Disorder)	11165 (Wisconsin)	Secondary
101YM0800X	Counselor - Mental Health	2898-123 (Wisconsin)	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. Brian L Boomgarden allows following entities to bill medicare on his behalf.

Entity Name	Froedtert Manitowoc Medical Group, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1437829975 PECOS PAC ID: 2365836954 Enrollment ID: O20220224001282

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. Brian L Boomgarden 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
Brian L Boomgarden, MS CADC Po Box 2290, Manitowoc, WI 54221-2290 Ph: (920) 320-8600	Brian L Boomgarden, MS CADC 339 Reed Ave, Manitowoc, WI 54220-2020 Ph: (920) 320-8600

Reviews and Comments

Counselor in Manitowoc, WI

Lana L. Roever, M.S., S.A.C.I.T. Counselor Medicare: Not Enrolled in Medicare Practice Location: 926 S. 8th Street, Manitowoc, WI 54221 Phone: 920-683-4230 Fax: 920-683-4908
Mrs. Corrin Laurene Applekamp, MS, LPC-IT, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3 Riverview Dr, Manitowoc, WI 54220 Phone: 920-663-1035
Courtney Balthazor, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3 Riverview Dr, Manitowoc, WI 54220 Phone: 920-663-1035 Fax: 920-215-4918
Kirstin Duprey, QTT Counselor Medicare: Not Enrolled in Medicare Practice Location: 926 S 8th St, Manitowoc, WI 54220 Phone: 920-683-4230
Austin David Lucas, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 926 South 8th Street, Manitowoc, WI 54221 Phone: 920-683-4230 Fax: 920-683-4908
Mrs. Paulette Marie Sears, MS LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 115 East Waldo Blvd, Manitowoc, WI 54220 Phone: 920-682-6087 Fax: 920-682-6087
Rachel Gordon, LPC, CSAC, CAS Counselor Medicare: Not Enrolled in Medicare Practice Location: 339 Reed Ave, Manitowoc, WI 54220 Phone: 920-320-8600 Fax: 920-320-8662

Brian L Boomgarden, MS CADC - Medicare Counselor in Manitowoc, WI