Ellen Grandaw Martin, in Random Lake, WI - Medicare Physical Therapy Provider

Ellen Grandaw Martin, is a medicare enrolled "Physical Therapist" provider in Random Lake, Wisconsin. She went to University Of Wisconsin School Of Medicine and graduated in 1992 and has 32 years of diverse experience with area of expertise as Physical Therapy. She is a member of the group practice Aegis Group Practice Llc and her current practice location is 621 Spring Ct, Random Lake, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 960-0505.

Ellen Grandaw Martin is licensed to practice in Wisconsin (license number 4431-24) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1902572571.

Contact Information

	Ellen Grandaw Martin,
	621 Spring Ct, Random Lake, WI 53075-1790
	(920) 960-0505
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Ellen Grandaw Martin
Gender	Female
Speciality	Physical Therapy
Experience	32 Years
Location	621 Spring Ct, Random Lake, Wisconsin
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Ellen Grandaw Martin attended and graduated from University Of Wisconsin School Of Medicine in 1992

NPI Data:

NPI Number: 1902572571
Provider Enumeration Date: 08/23/2021
Last Update Date: 08/23/2021

Medicare PECOS Information:

PECOS PAC ID: 1254729585
Enrollment ID: I20211019002174

Medical Identifiers

Medical identifiers for Ellen Grandaw Martin such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1902572571	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	4431-24 (Wisconsin)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Aegis Group Practice Llc	5193036432	267

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. Ellen Grandaw Martin allows following entities to bill medicare on her behalf.

Provider Name	Aegis Group Practice Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1275073363 PECOS PAC ID: 5193036432 Enrollment ID: O20170614002978

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. Ellen Grandaw Martin 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
Ellen Grandaw Martin, 621 Spring Ct, Random Lake, WI 53075-1790 Ph: (920) 960-0505	Ellen Grandaw Martin, 621 Spring Ct, Random Lake, WI 53075-1790 Ph: (920) 960-0505

Reviews and Comments

Physical Therapist in Random Lake, WI

Richard Polk, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: N546 Schroeter Dr, Random Lake, WI 53075 Phone: 920-207-3550 Fax: 920-994-4606
Pt Connections Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 233 Carroll St, Random Lake, WI 53075 Phone: 920-994-4515 Fax: 920-994-4583
Mrs. Marlena Elizabeth Salazar, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: N546 Schroeter Dr, Random Lake, WI 53075 Phone: 920-207-3550 Fax: 920-994-8466
Abby Lynn Risse, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 402 1st St, Random Lake, WI 53075 Phone: 920-994-9700 Fax: 920-994-4606
Mrs. Julie M. Schmitt, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: N546 Schroeter Dr, Random Lake, WI 53075 Phone: 920-994-9700
Michelle M Grace-jensen, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 233 Carroll St, Random Lake, WI 53075 Phone: 920-912-0058
Ms. Virginia K Bowen, P.T. Physical Therapist Medicare: Medicare Enrolled Practice Location: 402 First Street, Random Lake, WI 53075 Phone: 920-994-9700 Fax: 920-994-4606

Ellen Grandaw Martin, - Medicare Physical Therapist in Random Lake, WI