Richard Polk, PT in Random Lake, WI - Medicare Physical Therapist Provider

Richard Polk, PT is a medicare enrolled "Physical Therapist" provider in Random Lake, Wisconsin. His current practice location is N546 Schroeter Dr, Random Lake, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (920) 207-3550.

Richard Polk is licensed to practice in Wisconsin (license number 4734-024) 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 1225233323.

Contact Information

	Richard Polk, PT
	N546 Schroeter Dr, Random Lake, WI 53075-1272
	(920) 207-3550
	(920) 994-4606

Map and Direction

Healthcare Provider's Profile

Full Name	Richard Polk
Gender	Male
Speciality	Physical 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: 1225233323
Provider Enumeration Date: 06/19/2007
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 5890896245
Enrollment ID: I20070730000115

Medical Identifiers

Medical identifiers for Richard Polk such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1225233323	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	4734-024 (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. Richard Polk allows following entities to bill medicare on his behalf.

Provider Name	Great Lakes Healthcare Inc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1184282618 PECOS PAC ID: 5395079719 Enrollment ID: O20190730000104

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. Richard Polk 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
Richard Polk, PT N546 Schroeter Dr, Random Lake, WI 53075-1272 Ph: (920) 207-3550	Richard Polk, PT N546 Schroeter Dr, Random Lake, WI 53075-1272 Ph: (920) 207-3550

Reviews and Comments

Physical Therapist in Random Lake, WI

Jensen Interhealth 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: Not Enrolled in Medicare 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: Not Enrolled in Medicare Practice Location: 402 First Street, Random Lake, WI 53075 Phone: 920-994-9700 Fax: 920-994-4606

Richard Polk, PT - Medicare Physical Therapist in Random Lake, WI