John P Lacey Jr, is a medicare enrolled "Urology" physician in West Bend, Wisconsin. His current practice location is
3200 Pleasant Valley Rd, West Bend Clinic-urology, West Bend, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(262) 836-7300.
John P Lacey Jr is licensed to practice in Wisconsin (license number 31345) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1578645305.
Physician's Profile
| Full Name | John P Lacey Jr |
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| Gender | Male |
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| Speciality | Urology |
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| Location | 3200 Pleasant Valley Rd, West Bend, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1578645305
- Provider Enumeration Date: 10/20/2006
- Last Update Date: 09/05/2013
Medicare PECOS Information:
- PECOS PAC ID: 9537202510
- Enrollment ID: I20100201000056
Medical Identifiers
Medical identifiers for John P Lacey Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1578645305 | NPI | - | NPPES |
| 1578645305 | Medicaid | WI | |
| 7708 | Other | | INTERNAL ID-MOTOR VEHICLE ID |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208800000X | Urology | 31345 (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. John P Lacey Jr allows following entities to bill medicare on his behalf.
| Entity Name | The Medical College Of Wisconsin Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1699720086
PECOS PAC ID: 2668384371
Enrollment ID: O20031120000259 |
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| Entity Name | Froedtert &the Medical College Of Wisconsin Community Physicians Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1568787448
PECOS PAC ID: 3678760063
Enrollment ID: O20101210000699 |
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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. John P Lacey Jr 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 |
|---|
John P Lacey Jr,
3200 Pleasant Valley Rd, West Bend Clinic-urology,
West Bend, WI 53095-9274
Ph: (262) 836-7300 | John P Lacey Jr,
3200 Pleasant Valley Rd, West Bend Clinic-urology,
West Bend, WI 53095-9274
Ph: (262) 836-7300 |
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