Dr Lance Fay Haseltine, MD is a medicare enrolled "General Practice" physician in Shell Lake, Wisconsin. His current practice location is
24521 Poquette Lake Rd, Shell Lake, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(612) 991-4889.
Dr Lance Fay Haseltine is licensed to practice in Wisconsin (license number 35039-20) 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 1093010001.
Physician's Profile
Full Name | Dr Lance Fay Haseltine |
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Gender | Male |
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Speciality | General Practice |
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Location | 24521 Poquette Lake Rd, Shell Lake, Wisconsin |
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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: 1093010001
- Provider Enumeration Date: 01/22/2011
- Last Update Date: 03/04/2025
Medicare PECOS Information:
- PECOS PAC ID: 6800322728
- Enrollment ID: I20241216000276
Medical Identifiers
Medical identifiers for Dr Lance Fay Haseltine such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1093010001 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208D00000X | General Practice | 33541 (Minnesota) | Secondary |
208D00000X | General Practice | 35039-20 (Wisconsin) | 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. Dr Lance Fay Haseltine 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 |
Dr Lance Fay Haseltine, MD 24521 Poquette Lake Rd, Shell Lake, WI 54871-9240 Ph: (612) 991-4889 | Dr Lance Fay Haseltine, MD 24521 Poquette Lake Rd, Shell Lake, WI 54871-9240 Ph: (612) 991-4889 |
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