Ms Vanessa Lissette Lara, FNP-C is a medicare enrolled "Nurse Practitioner - Family" physician in Peoria, Arizona. Her current practice location is
9139 W Thunderbird Rd Ste 265, Peoria, Arizona. You can reach out to her office (for appointments etc.) via phone at
(623) 777-4567.
Ms Vanessa Lissette Lara is licensed to practice in Arizona (license number 230762) 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 1861033912.
Physician's Profile
Full Name | Ms Vanessa Lissette Lara |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 9139 W Thunderbird Rd Ste 265, Peoria, Arizona |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1861033912
- Provider Enumeration Date: 09/30/2019
- Last Update Date: 06/30/2021
Medicare PECOS Information:
- PECOS PAC ID: 4385078658
- Enrollment ID: I20191218003106
Medical Identifiers
Medical identifiers for Ms Vanessa Lissette Lara such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1861033912 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 230762 (Arizona) | Secondary |
363LF0000X | Nurse Practitioner - Family | 230762 (Arizona) | 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. Ms Vanessa Lissette Lara allows following entities to bill medicare on her behalf.
Entity Name | M Zuhdi Jasser Md Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1932290897 PECOS PAC ID: 0446214662 Enrollment ID: O20041117000808 |
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Entity Name | Guggiari Med Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1457765695 PECOS PAC ID: 5496975476 Enrollment ID: O20140926000566 |
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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 Vanessa Lissette Lara 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 |
Ms Vanessa Lissette Lara, FNP-C 9139 W Thunderbird Rd Ste 265, Peoria, AZ 85381-4922 Ph: () - | Ms Vanessa Lissette Lara, FNP-C 9139 W Thunderbird Rd Ste 265, Peoria, AZ 85381-4922 Ph: (623) 777-4567 |
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