Mr Eric Tabamo Guzman, MS, MFT is a medicare enrolled "Marriage & Family Therapist" provider in Monroe, Wisconsin. His current practice location is
2009 5th St, Monroe, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(608) 324-2000.
Mr Eric Tabamo Guzman is licensed to practice in Wisconsin (license number 974-124) 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 1558694125.
Healthcare Provider's Profile
| Full Name | Mr Eric Tabamo Guzman |
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| Gender | Male |
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| Speciality | Marriage & Family Therapist |
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| Location | 2009 5th St, Monroe, 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: 1558694125
- Provider Enumeration Date: 09/14/2009
- Last Update Date: 04/03/2024
Medicare PECOS Information:
- PECOS PAC ID: 0244680890
- Enrollment ID: I20231222002251
Medical Identifiers
Medical identifiers for Mr Eric Tabamo Guzman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1558694125 | NPI | - | NPPES |
| 1558694125 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 106H00000X | Marriage & Family Therapist | 974-124 (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. Mr Eric Tabamo Guzman allows following entities to bill medicare on his behalf.
| Entity Name | The Monroe Clinic Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1386720548
PECOS PAC ID: 3072425495
Enrollment ID: O20031104000392 |
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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. Mr Eric Tabamo Guzman 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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Mr Eric Tabamo Guzman, MS, MFT
324 River St,
Portage, WI 53901-1946
Ph: (608) 617-4173 | Mr Eric Tabamo Guzman, MS, MFT
2009 5th St,
Monroe, WI 53566-1546
Ph: (608) 324-2000 |
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