Kathleen R Lundeberg, DO is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Dayton, Ohio. Her current practice location is
1 Wyoming St, Dayton, Ohio. You can reach out to her office (for appointments etc.) via phone at
(937) 212-3207.
Kathleen R Lundeberg is licensed to practice in * (Not Available) (license number ) 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 1407425358.
Physician's Profile
| Full Name | Kathleen R Lundeberg |
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| Gender | Female |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 1 Wyoming St, Dayton, Ohio |
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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: 1407425358
- Provider Enumeration Date: 06/23/2021
- Last Update Date: 02/11/2026
Medicare PECOS Information:
- PECOS PAC ID: 9931588670
- Enrollment ID: I20220627000915
Medical Identifiers
Medical identifiers for Kathleen R Lundeberg such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1407425358 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207V00000X | Obstetrics & Gynecology | 34.016995 (Ohio) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
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. Kathleen R Lundeberg 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 |
Kathleen R Lundeberg, DO 1 Wyoming St, Dayton, OH 45409-2722 Ph: () - | Kathleen R Lundeberg, DO 1 Wyoming St, Dayton, OH 45409-2722 Ph: (937) 212-3207 |
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