Tina C Brossow, is a medicare enrolled "Nurse Practitioner - Family" in Withee, Wisconsin. Her current practice location is
N16012 Cty Rd T, Withee, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(872) 231-3162.
Tina C Brossow is licensed to practice in Wisconsin (license number 8487-33) 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 1518444694.
Provider's Profile
| Full Name | Tina C Brossow |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | N16012 Cty Rd T, Withee, 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: 1518444694
- Provider Enumeration Date: 07/23/2018
- Last Update Date: 05/07/2026
Medicare PECOS Information:
- PECOS PAC ID: 5294065843
- Enrollment ID: I20190924002240
Medical Identifiers
Medical identifiers for Tina C Brossow such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1518444694 | NPI | - | NPPES |
| 100088479 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363LF0000X | Nurse Practitioner - Family | 8487-33 (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. Tina C Brossow allows following entities to bill medicare on her behalf.
| Entity Name | Gateways Counseling Services, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1811489206 PECOS PAC ID: 9638407786 Enrollment ID: O20190827002930 |
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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. Tina C Brossow 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 |
Tina C Brossow, Po Box 74008272, Chicago, IL 60674-8272 Ph: (872) 231-3162 | Tina C Brossow, N16012 Cty Rd T, Withee, WI 54498-8353 Ph: (872) 231-3162 |
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