Mardon Ellen So, is a medicare enrolled "Physical Therapist" provider in Grand Marais, Minnesota. She graduated from medical school in 2023 and has 3 years of diverse experience with area of expertise as Physical Therapist In Private Practice. She is a member of the group practice Multicare Health System and her current practice location is
515 5th Ave W, Grand Marais, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(218) 387-3040.
Mardon Ellen So is licensed to practice in Minnesota (license number 13275) 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 1063238095.
Healthcare Provider's Profile
| Full Name | Mardon Ellen So |
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| Gender | Female |
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| Speciality | Physical Therapist In Private Practice |
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| Experience | 3 Years |
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| Location | 515 5th Ave W, Grand Marais, Minnesota |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mardon Ellen So graduated from medical school in 2023
NPI Data:
- NPI Number: 1063238095
- Provider Enumeration Date: 11/25/2024
- Last Update Date: 11/25/2024
Medicare PECOS Information:
- PECOS PAC ID: 6608396304
- Enrollment ID: I20250225002913
Medical Identifiers
Medical identifiers for Mardon Ellen So such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1063238095 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225100000X | Physical Therapist | 13275 (Minnesota) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Multicare Health System | 7719899897 | 1815 |
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. Mardon Ellen So allows following entities to bill medicare on her behalf.
| Provider Name | Multicare Health System |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1497766638
PECOS PAC ID: 7719899897
Enrollment ID: O20031105000760 |
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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. Mardon Ellen So 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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Mardon Ellen So,
515 5th Ave W,
Grand Marais, MN 55604-3017
Ph: (218) 387-3040 | Mardon Ellen So,
515 5th Ave W,
Grand Marais, MN 55604-3017
Ph: (218) 387-3040 |
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