Leslie Wallace Bray, MSN, FNP-C is a medicare enrolled "Family Medicine" physician in Lincolnville, Maine. Her current practice location is
2399 Atlantic Hwy, Lincolnville, Maine. You can reach out to her office (for appointments etc.) via phone at
(207) 236-4851.
Leslie Wallace Bray is licensed to practice in Maine (license number CNP191092) 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 1407416373.
Physician's Profile
| Full Name | Leslie Wallace Bray |
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| Gender | Female |
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| Speciality | Family Medicine |
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| Location | 2399 Atlantic Hwy, Lincolnville, Maine |
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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: 1407416373
- Provider Enumeration Date: 06/13/2019
- Last Update Date: 06/13/2019
Medicare PECOS Information:
- PECOS PAC ID: 2769814425
- Enrollment ID: I20191118002937
Medical Identifiers
Medical identifiers for Leslie Wallace Bray such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1407416373 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | CNP191092 (Maine) | 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. Leslie Wallace Bray allows following entities to bill medicare on her behalf.
| Entity Name | Mainehealth |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1790265502
PECOS PAC ID: 7517860588
Enrollment ID: O20040701000166 |
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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. Leslie Wallace Bray 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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Leslie Wallace Bray, MSN, FNP-C
Po Box 452,
Owls Head, ME 04854-0452
Ph: (207) 691-2140 | Leslie Wallace Bray, MSN, FNP-C
2399 Atlantic Hwy,
Lincolnville, ME 04849-5322
Ph: (207) 236-4851 |
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