Emily Fowler Bemben, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" provider in Grand Rapids, Michigan. She graduated from healthcare school in 2019 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Lyn-lake Psychotherapy And Wellness Ltd and her current practice location is
72 Sheldon Ave Se, Grand Rapids, Michigan. You can reach out to her office (for appointments etc.) via phone at
(616) 331-9830.
Emily Fowler Bemben is licensed to practice in Minnesota (license number 6704) and she also participates in the medicare program. She
may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1760897375.
Healthcare Provider's Profile
| Full Name | Emily Fowler Bemben |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 6 Years |
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| Location | 72 Sheldon Ave Se, Grand Rapids, Michigan |
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| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Emily Fowler Bemben graduated from medical school in 2019
NPI Data:
- NPI Number: 1760897375
- Provider Enumeration Date: 06/23/2014
- Last Update Date: 04/12/2021
Medicare PECOS Information:
- PECOS PAC ID: 1456680859
- Enrollment ID: I20190910003651
Medical Identifiers
Medical identifiers for Emily Fowler Bemben such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1760897375 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 163W00000X | Registered Nurse | 2475459 (Minnesota) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 6704 (Minnesota) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Lyn-lake Psychotherapy And Wellness Ltd | 9638581291 | 51 |
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. Emily Fowler Bemben allows following entities to bill medicare on her behalf.
| Entity Name | Native American Community Clinic |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1932258845
PECOS PAC ID: 8224921978
Enrollment ID: O20040205000844 |
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| Entity Name | Lyn-lake Psychotherapy And Wellness Ltd |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1609355163
PECOS PAC ID: 9638581291
Enrollment ID: O20201224000071 |
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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. Emily Fowler Bemben 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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Emily Fowler Bemben, PMHNP-BC
72 Sheldon Ave Se,
Grand Rapids, MI 49503-4234
Ph: (650) 814-1276 | Emily Fowler Bemben, PMHNP-BC
72 Sheldon Ave Se,
Grand Rapids, MI 49503-4234
Ph: (616) 331-9830 |
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