Ms Mary J Crockett, OTRL - Medicare Occupational Therapist in Superior, WI

Ms Mary J Crockett, OTRL is a medicare enrolled "Occupational Therapist" provider in Superior, Wisconsin. Her current practice location is 1800 New York Ave, Superior, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (715) 394-5591.

Ms Mary J Crockett is licensed to practice in Wisconsin (license number 4163026) 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 1417160169.

Contact Information

Ms Mary J Crockett, OTRL
1800 New York Ave,
Superior, WI 54880
(715) 394-5591
Not Available



Healthcare Provider's Profile

Full NameMs Mary J Crockett
GenderFemale
SpecialityOccupational Therapist
Location1800 New York Ave, Superior, Wisconsin
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1417160169
  • Provider Enumeration Date: 05/08/2007
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 7719104892
  • Enrollment ID: I20140813002070

Medical Identifiers

Medical identifiers for Ms Mary J Crockett such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1417160169NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225X00000XOccupational Therapist 4163026 (Wisconsin)Primary
225X00000XOccupational Therapist 101276 (Minnesota)Secondary

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. Ms Mary J Crockett allows following entities to bill medicare on her behalf.
Provider NameAvera Marshall
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1568401016
PECOS PAC ID: 5799695227
Enrollment ID: O20031106000219

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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. Ms Mary J Crockett 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
Ms Mary J Crockett, OTRL
21 Green Lane,
Silver Bay, MN 55614-1235

Ph: (218) 226-0194
Ms Mary J Crockett, OTRL
1800 New York Ave,
Superior, WI 54880

Ph: (715) 394-5591

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› Verified 3 days ago


Occupational Therapist in Superior, WI

Allison N Kostreba, OTR/L
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 35 N 28th St, Superior, WI 54880
Phone: 763-219-5521    
Anastasia Pitzen, OTR/L
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 1915 N 34th St, Superior, WI 54880
Phone: 715-399-3287    
Brenda Christine Baker,
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 3500 Tower Ave, Superior, WI 54880
Phone: 715-395-5454    
Lonni Marie Brickson,
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 3500 Tower Ave, Superior, WI 54880
Phone: 715-395-5454    
Paula Bjoralt, OTR
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 39 N 25th St E, Superior, WI 54880
Phone: 763-689-5385    Fax: 763-689-5558
Kelsey Rubatt, OTR
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 1612 N 37th St, Superior, WI 54880
Phone: 715-718-2101    

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