Mrs Nichole M Elmendorf, OTR - Medicare Occupational Therapist in Sheboygan, WI

Mrs Nichole M Elmendorf, OTR is a medicare enrolled "Occupational Therapist - Pediatrics" provider in Sheboygan, Wisconsin. Her current practice location is 1125 N 13th St, Sheboygan, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 803-1617.

Mrs Nichole M Elmendorf is licensed to practice in Wisconsin (license number 2461) 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 1255519443.

Contact Information

Mrs Nichole M Elmendorf, OTR
1125 N 13th St,
Sheboygan, WI 53081-3281
(920) 803-1617
(920) 803-1622



Healthcare Provider's Profile

Full NameMrs Nichole M Elmendorf
GenderFemale
SpecialityOccupational Therapist - Pediatrics
Location1125 N 13th St, Sheboygan, Wisconsin
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1255519443
  • Provider Enumeration Date: 02/10/2008
  • Last Update Date: 10/10/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 8022281864
  • Enrollment ID: I20141229000314

Medical Identifiers

Medical identifiers for Mrs Nichole M Elmendorf such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1255519443NPI-NPPES
40806400MedicaidWI
41813000MedicaidWI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225XP0200XOccupational Therapist - Pediatrics 2461 (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. Mrs Nichole M Elmendorf allows following entities to bill medicare on her behalf.
Provider NameProgressive Beginnings, Llc
Provider TypePart B Supplier - Physical/occupational Therapy Group In Private Practice
Provider IdentifiersNPI Number: 1598886152
PECOS PAC ID: 7012189848
Enrollment ID: O20141208001324

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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. Mrs Nichole M Elmendorf 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 AddressPractice Location Address
Mrs Nichole M Elmendorf, OTR
1125 N 13th St,
Sheboygan, WI 53081-3281

Ph: (920) 803-1617
Mrs Nichole M Elmendorf, OTR
1125 N 13th St,
Sheboygan, WI 53081-3281

Ph: (920) 803-1617

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Occupational Therapist in Sheboygan, WI

Emily Joann Lucht, M.S. OTR/L
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 3613 S 13th St, Sheboygan, WI 53081
Phone: 715-572-5893    
Joshua R Luna, OTR
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 2131 S Business Dr, Sheboygan, WI 53081
Phone: 920-803-1617    Fax: 920-803-1622
Hailey Witthun, OTR
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 1125 N 13th St, Sheboygan, WI 53081
Phone: 920-803-1617    
Ashley L Coop, OTR/L
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 2508 Cooper Ave, Sheboygan, WI 53083
Phone: 920-838-4595    
Mrs. Ann M Hering, OTR
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 1125 N 13th St, Sheboygan, WI 53081
Phone: 920-208-9648    
Mrs. Amy Kate Summers, OTR
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 2629 N 7th St, Sheboygan, WI 53083
Phone: 920-451-5550    
Sarah M Keller, OTR
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 1125 N 13th St, Sheboygan, WI 53081
Phone: 920-208-9648    Fax: 920-208-6316

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