Lighthouse Mental Wellness Pllc - Medicare in Pembroke, MA

  1. Home
Lighthouse Mental Wellness Pllc is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" provider in Pembroke, Massachusetts. Their current practice location is 28 Riverside Dr Ste 260, Pembroke, Massachusetts. You can reach out to their office (for appointments etc.) via phone at (781) 472-7070.

Lighthouse Mental Wellness Pllc is licensed to practice in NU (license number ) and it also participates in the medicare program. Lighthouse Mental Wellness Pllc is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1821564790.

Contact Information

Lighthouse Mental Wellness Pllc
28 Riverside Dr Ste 260,
Pembroke, MA 02359-4947
(781) 472-7070
(781) 472-7071

Map and Direction




Healthcare Provider's Profile

Full NameLighthouse Mental Wellness Pllc
TypeFacility
SpecialityNurse Practitioner - Psychiatric/mental Health
Location28 Riverside Dr Ste 260, Pembroke, Massachusetts
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1821564790
  • Provider Enumeration Date: 10/18/2018
  • Last Update Date: 01/13/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 5698206324
  • Enrollment ID: O20241004000665

Medical Identifiers

Medical identifiers for Lighthouse Mental Wellness Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1821564790NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
133V00000XDietitian, Registered (NU)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health (NU)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Lighthouse Mental Wellness Pllc acts as a billing entity for following providers:
Provider NameMeredith B Detwiler
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1881834174
PECOS PAC ID: 6204993504
Enrollment ID: I20090331000209
Provider NameBrian S Banks
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780067645
PECOS PAC ID: 5698076677
Enrollment ID: I20151216001330
Provider NameLisa Costa
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790335214
PECOS PAC ID: 6204246952
Enrollment ID: I20210304002831
Provider NameSamantha Bondaryk
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508310608
PECOS PAC ID: 4284089038
Enrollment ID: I20231013000998
Provider NameMichelle Suesann Arancio
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1225637770
PECOS PAC ID: 8820528110
Enrollment ID: I20250217001694
Provider NameJill Kathryn Marshall
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1326747601
PECOS PAC ID: 7719407972
Enrollment ID: I20250219001209

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. Lighthouse Mental Wellness Pllc 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
Lighthouse Mental Wellness Pllc
28 Riverside Dr Ste 260,
Pembroke, MA 02359-4947

Ph: (781) 427-7070		Lighthouse Mental Wellness Pllc
28 Riverside Dr Ste 260,
Pembroke, MA 02359-4947

Ph: (781) 472-7070

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.