Kirby Kaczor, LPCC - Medicare Counselor in White Bear Lake, MN

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Kirby Kaczor, LPCC is a medicare enrolled "Counselor" provider in White Bear Lake, Minnesota. His current practice location is 2025 4th St Ste 100, White Bear Lake, Minnesota. You can reach out to his office (for appointments etc.) via phone at (651) 212-4920.

Kirby Kaczor is licensed to practice in Minnesota (license number 4263) 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 1003679234.

Contact Information

Kirby Kaczor, LPCC
2025 4th St Ste 100,
White Bear Lake, MN 55110-2875
(651) 212-4920
Not Available

Map and Direction


Healthcare Provider's Profile

Full NameKirby Kaczor
GenderMale
SpecialityCounselor
Location2025 4th St Ste 100, White Bear Lake, Minnesota
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1003679234
  • Provider Enumeration Date: 01/31/2024
  • Last Update Date: 01/31/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 7911341102
  • Enrollment ID: I20240215001691

Medical Identifiers

Medical identifiers for Kirby Kaczor such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003679234NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101Y00000XCounselor 4263 (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. Kirby Kaczor allows following entities to bill medicare on his behalf.
Entity NameWild Tree Psychotherapy Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1528451408
PECOS PAC ID: 8426408881
Enrollment ID: O20231227001431
Entity NameCollaborative Psychiatric Services Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1699525857
PECOS PAC ID: 5496196115
Enrollment ID: O20240513002614
Entity NameVantage Mental Health
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1538990288
PECOS PAC ID: 4587104815
Enrollment ID: O20240912002740

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. Kirby Kaczor 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 AddressPractice Location Address
Kirby Kaczor, LPCC
2025 4th St Ste 100,
White Bear Lake, MN 55110-2875

Ph: (651) 212-4920		Kirby Kaczor, LPCC
2025 4th St Ste 100,
White Bear Lake, MN 55110-2875

Ph: (651) 212-4920

Reviews and Comments


Counselor in White Bear Lake, MN

Diana Sue Finney, LADC, MA
Counselor
Medicare: Not Enrolled in Medicare
Practice Location: 2179 4th St Ste 2b, White Bear Lake, MN 55110
Phone: 651-705-7872    
Mrs. Tabitha Soderstrom, MS
Counselor
Medicare: Not Enrolled in Medicare
Practice Location: 3596 Linden Ave, White Bear Lake, MN 55110
Phone: 507-215-2459    
Christina Castaneda, LPC
Counselor
Medicare: Not Enrolled in Medicare
Practice Location: 2025 4th St Ste 100, White Bear Lake, MN 55110
Phone: 651-212-4920    
Mr. Andrew Clark Hoistad,
Counselor
Medicare: Not Enrolled in Medicare
Practice Location: 1245 Gun Club Rd, White Bear Lake, MN 55110
Phone: 612-644-4887    
Chester Mulholland, LPCC
Counselor
Medicare: Medicare Enrolled
Practice Location: 3596 Linden Ave, White Bear Lake, MN 55110
Phone: 651-243-2484    
Julie Blaske, MA LADC LMFT
Counselor
Medicare: Medicare Enrolled
Practice Location: 1310 Hwy 96 E, Suite 200, White Bear Lake, MN 55110
Phone: 612-241-6004    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.