Amanda Marie Halls, RD is a medicare enrolled "Dietitian, Registered" provider in Lake City, Minnesota. Her current practice location is
500 W Grant St, Lake City, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(651) 345-1187.
Amanda Marie Halls is licensed to practice in Minnesota (license number 3601) 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 1801264742.
Healthcare Provider's Profile
| Full Name | Amanda Marie Halls |
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| Gender | Female |
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| Speciality | Dietitian, Registered |
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| Location | 500 W Grant St, Lake City, Minnesota |
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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: 1801264742
- Provider Enumeration Date: 09/09/2015
- Last Update Date: 02/18/2025
Medicare PECOS Information:
- PECOS PAC ID: 6800144072
- Enrollment ID: I20180803000898
Medical Identifiers
Medical identifiers for Amanda Marie Halls such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1801264742 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 133V00000X | Dietitian, Registered | 994439 (Minnesota) | Secondary |
| 133V00000X | Dietitian, Registered | 3601 (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. Amanda Marie Halls allows following entities to bill medicare on her behalf.
| Provider Name | Mayo Clinic Health System-lake City |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1164463659
PECOS PAC ID: 1951213487
Enrollment ID: O20031104000095 |
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| Provider Name | Mayo Clinic Health System-lake City |
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| Provider Type | Part A Provider - Critical Access Hospital |
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| Provider Identifiers | NPI Number: 1538113022
PECOS PAC ID: 1951213487
Enrollment ID: O20070711000490 |
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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. Amanda Marie Halls 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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Amanda Marie Halls, RD
Po Box 860912,
Minneapolis, MN 55486-0912
Ph: (651) 345-3321 | Amanda Marie Halls, RD
500 W Grant St,
Lake City, MN 55041-1143
Ph: (651) 345-1187 |
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