Lacey Lundgren, APRN is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" physician in Bastrop, Texas. Her current practice location is
1128 Tx-21, Bastrop, Texas. You can reach out to her office (for appointments etc.) via phone at
(844) 215-4498.
Lacey Lundgren is licensed to practice in Texas (license number AP125777) 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 1689088205.
Physician's Profile
| Full Name | Lacey Lundgren |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 1128 Tx-21, Bastrop, Texas |
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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: 1689088205
- Provider Enumeration Date: 06/12/2014
- Last Update Date: 08/29/2024
Medicare PECOS Information:
- PECOS PAC ID: 8426270596
- Enrollment ID: I20141105002608
Medical Identifiers
Medical identifiers for Lacey Lundgren such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1689088205 | NPI | - | NPPES |
| 342462401 | Medicaid | TX | |
| 791283 | Other | TX | RN LICENSE |
| AP125777 | Other | TX | APRN LICENSE NO. |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | AP125777 (Texas) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | AP125777 (Texas) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | AP125777 (Texas) | 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. Lacey Lundgren allows following entities to bill medicare on her behalf.
| Entity Name | Bluebonnet Trails Community Mhmr Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1730135864
PECOS PAC ID: 5799775409
Enrollment ID: O20040514000751 |
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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. Lacey Lundgren 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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Lacey Lundgren, APRN
16800 Lund Rd N,
Elgin, TX 78621-3830
Ph: (512) 413-5190 | Lacey Lundgren, APRN
1128 Tx-21,
Bastrop, TX 78602-4298
Ph: (844) 215-4498 |
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