Shanna Rose Thomsen, is a medicare enrolled "Psychologist - Clinical" provider in Milwaukee, Wisconsin. Her current practice location is
9205 W Center St Ste 200, Milwaukee, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(414) 279-9082.
Shanna Rose Thomsen is licensed to practice in Wisconsin (license number 3972-57) 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 1417438250.
Healthcare Provider's Profile
| Full Name | Shanna Rose Thomsen |
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| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 9205 W Center St Ste 200, Milwaukee, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1417438250
- Provider Enumeration Date: 08/28/2018
- Last Update Date: 06/05/2023
Medicare PECOS Information:
- PECOS PAC ID: 6204232531
- Enrollment ID: I20210910002168
Medical Identifiers
Medical identifiers for Shanna Rose Thomsen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1417438250 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | 3972-57 (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. Shanna Rose Thomsen allows following entities to bill medicare on her behalf.
| Entity Name | Professional Services Group Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1619024262 PECOS PAC ID: 8224296454 Enrollment ID: O20120220000742 |
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| Entity Name | Intentional Psychology Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1699469411 PECOS PAC ID: 7416315247 Enrollment ID: O20230626002994 |
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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. Shanna Rose Thomsen 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 |
Shanna Rose Thomsen, 9205 W Center St Ste 200, Milwaukee, WI 53222-4548 Ph: (414) 279-9082 | Shanna Rose Thomsen, 9205 W Center St Ste 200, Milwaukee, WI 53222-4548 Ph: (414) 279-9082 |
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