Miss Susan Shopodock, CLINICAL SOCIAL WORK is a medicare enrolled "Social Worker - Clinical" provider in Manitowoc, Wisconsin. She graduated from healthcare school in 2021 and has 5 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Great Lakes Clinic And Consultants and her current practice location is
816 Washington St, Manitowoc, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(920) 645-3743.
Miss Susan Shopodock is licensed to practice in Wisconsin (license number 11553-123) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1225743230.
Healthcare Provider's Profile
| Full Name | Miss Susan Shopodock |
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| Gender | Female |
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| Speciality | Clinical Social Worker |
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| Experience | 5 Years |
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| Location | 816 Washington St, Manitowoc, Wisconsin |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Miss Susan Shopodock graduated from medical school in 2021
NPI Data:
- NPI Number: 1225743230
- Provider Enumeration Date: 01/16/2023
- Last Update Date: 07/24/2024
Medicare PECOS Information:
- PECOS PAC ID: 2860929379
- Enrollment ID: I20241223001300
Medical Identifiers
Medical identifiers for Miss Susan Shopodock such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1225743230 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 19773 (Wisconsin) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 104100000X | Social Worker | 11553-123 (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 11553-123 (Wisconsin) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Great Lakes Clinic And Consultants | 9335664549 | 2 |
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. Miss Susan Shopodock allows following entities to bill medicare on her behalf.
| Entity Name | Summit Clinical Services Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1417605551
PECOS PAC ID: 4486095486
Enrollment ID: O20240508001756 |
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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. Miss Susan Shopodock 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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Miss Susan Shopodock, CLINICAL SOCIAL WORK
816 Washington St,
Manitowoc, WI 54220-4537
Ph: (920) 652-6065 | Miss Susan Shopodock, CLINICAL SOCIAL WORK
816 Washington St,
Manitowoc, WI 54220-4537
Ph: (920) 645-3743 |
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