Sarah Jane Petersen, LCSW is a medicare enrolled "Social Worker" provider in Beloit, Wisconsin. Her current practice location is
540 E Grand Ave, Beloit, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(608) 368-8087.
Sarah Jane Petersen is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1073228607.
Healthcare Provider's Profile
| Full Name | Sarah Jane Petersen |
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| Gender | Female |
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| Speciality | Social Worker |
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| Location | 540 E Grand Ave, Beloit, Wisconsin |
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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: 1073228607
- Provider Enumeration Date: 01/18/2023
- Last Update Date: 05/01/2024
Medicare PECOS Information:
- PECOS PAC ID: 7719337542
- Enrollment ID: I20231220001260
Medical Identifiers
Medical identifiers for Sarah Jane Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1073228607 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 104100000X | Social Worker | (* (Not Available)) | 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. Sarah Jane Petersen allows following entities to bill medicare on her behalf.
| Entity Name | Stateline Mental Health Services |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1538560255
PECOS PAC ID: 1658655865
Enrollment ID: O20170308001000 |
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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. Sarah Jane Petersen 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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Sarah Jane Petersen, LCSW
540 E Grand Ave,
Beloit, WI 53511-6314
Ph: (608) 368-8087 | Sarah Jane Petersen, LCSW
540 E Grand Ave,
Beloit, WI 53511-6314
Ph: (608) 368-8087 |
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