Bennet Petersen, MS, OTR/L in Kenosha, WI - Medicare Occupational Therapist Provider

Bennet Petersen, MS, OTR/L is a medicare enrolled "Occupational Therapist" provider in Kenosha, Wisconsin. His current practice location is 10222 74th St Ste 211, Kenosha, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (262) 925-5020.

Bennet Petersen is licensed to practice in Wisconsin (license number 6674-26) 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 1700166295.

Contact Information

	Bennet Petersen, MS, OTR/L
	10222 74th St Ste 211, Kenosha, WI 53142-6810
	(262) 925-5020
	(262) 925-5021

Map and Direction

Healthcare Provider's Profile

Full Name	Bennet Petersen
Gender	Male
Speciality	Occupational Therapist
Location	10222 74th St Ste 211, Kenosha, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1700166295
Provider Enumeration Date: 08/28/2011
Last Update Date: 06/05/2020

Medicare PECOS Information:

PECOS PAC ID: 9830511740
Enrollment ID: I20200623001981

Medical Identifiers

Medical identifiers for Bennet Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1700166295	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225X00000X	Occupational Therapist	6674-26 (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. Bennet Petersen allows following entities to bill medicare on his behalf.

Provider Name	Advantage Physical Therapy & Sports Rehab, Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1881773463 PECOS PAC ID: 8022016336 Enrollment ID: O20061121000412

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. Bennet Petersen 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
Bennet Petersen, MS, OTR/L 3921 30th Ave Ste C, Kenosha, WI 53144-1957 Ph: (262) 925-5004	Bennet Petersen, MS, OTR/L 10222 74th St Ste 211, Kenosha, WI 53142-6810 Ph: (262) 925-5020

Reviews and Comments

Occupational Therapist in Kenosha, WI

Richa Kamble, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 5060 Green Bay Rd, Kenosha, WI 53144 Phone: 262-825-0912
Lacy Nowicki, OTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 10222 74th St Ste 211, Kenosha, WI 53142 Phone: 262-925-5020
Ana Jones, OTR Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 1406 91st St Apt 103, Kenosha, WI 53143 Phone: 262-331-3414
Ms. Jane E Meyers, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 4103 60th St, Kenosha, WI 53144 Phone: 262-652-1111 Fax: 262-652-1124
Rachel Lauren Cole, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3100 Washington Rd, Kenosha, WI 53144 Phone: 248-930-4737
Mrs. Silvana K Leone, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 6308 8th Ave, Kenosha, WI 53143 Phone: 262-656-3299
Mrs. Jill Marie Fonk, MS, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3100 Washington Rd, Kenosha, WI 53144 Phone: 262-658-4074

Bennet Petersen, MS, OTR/L - Medicare Occupational Therapist in Kenosha, WI