Badieh Widmer, OTR in Random Lake, WI - Medicare Occupational Therapist Provider

Badieh Widmer, OTR is a medicare enrolled "Occupational Therapist" provider in Random Lake, Wisconsin. Her current practice location is N546 Schroeter Dr, Random Lake, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 207-3550.

Badieh Widmer is licensed to practice in Wisconsin (license number 3207-026) 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 1114086881.

Contact Information

	Badieh Widmer, OTR
	N546 Schroeter Dr, Random Lake, WI 53075-1272
	(920) 207-3550
	(920) 994-4606

Map and Direction

Healthcare Provider's Profile

Full Name	Badieh Widmer
Gender	Female
Speciality	Occupational Therapist
Location	N546 Schroeter Dr, Random Lake, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1114086881
Provider Enumeration Date: 12/08/2006
Last Update Date: 01/03/2025

Medicare PECOS Information:

PECOS PAC ID: 3072515949
Enrollment ID: I20250513001757

Medical Identifiers

Medical identifiers for Badieh Widmer such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114086881	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225X00000X	Occupational Therapist	3207-026 (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. Badieh Widmer allows following entities to bill medicare on her behalf.

Provider Name	Phoenix Mountain Therapy Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1053122689 PECOS PAC ID: 0648797944 Enrollment ID: O20250509001696

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. Badieh Widmer 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
Badieh Widmer, OTR N546 Schroeter Dr, Random Lake, WI 53075-1272 Ph: (920) 207-3550	Badieh Widmer, OTR N546 Schroeter Dr, Random Lake, WI 53075-1272 Ph: (920) 207-3550

Reviews and Comments

Occupational Therapist in Random Lake, WI

Jill Shea Suess, OTR Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 402 First Street, Random Lake, WI 53075 Phone: 920-994-9700 Fax: 920-994-4606
Mrs. Valerie Jean Stone, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 402 First Street, Random Lake, WI 53075 Phone: 262-343-0520
Mrs. Barbara Junge Mueller, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: N546 Schroeter Dr, Random Lake, WI 53075 Phone: 920-207-3550 Fax: 920-994-8466
Elizabeth Marie Theis, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 222 Christines Way, Random Lake, WI 53075 Phone: 920-889-5056
Megan C Horn, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 402 First Street, Random Lake, WI 53075 Phone: 920-994-9700 Fax: 920-994-4606
Kathleen Mary Kohlbeck, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: N546 Schroeter Dr, Random Lake, WI 53075 Phone: 920-207-3550 Fax: 920-994-4606

Badieh Widmer, OTR - Medicare Occupational Therapist in Random Lake, WI