| Mario Dante Lacerna, MD | |
|
1501 W Chisholm St, Alpena, MI 49707-1401 | |
| (888) 356-7151 | |
| Not Available |
| Full Name | Mario Dante Lacerna |
|---|---|
| Gender | Male |
| Speciality | Radiation Oncology |
| Experience | 33 Years |
| Location | 1501 W Chisholm St, Alpena, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326130725 | NPI | - | NPPES |
| 4303114 | Medicaid | MI | |
| 4375200 | Medicaid | FL | |
| FT108Y | Other | FL | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0001X | Radiology - Radiation Oncology | ME111595 (Florida) | Secondary |
| 2085R0001X | Radiology - Radiation Oncology | 4301059592 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Midmichigan Medical Center - Alpena | Alpena, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Northeastern Michigan Cancer Center | 0840285904 | 5 |
| Entity Name | Mymichigan Medical Center Alpena |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508332792 PECOS PAC ID: 8527969922 Enrollment ID: O20040415000495 |
| Entity Name | Northeastern Michigan Cancer Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275567869 PECOS PAC ID: 0840285904 Enrollment ID: O20040417000515 |
| Mailing Address | Practice Location Address |
|---|---|
| Mario Dante Lacerna, MD 3621 S State St, Ann Arbor, MI 48108-1633 Ph: (734) 647-5299 | Mario Dante Lacerna, MD 1501 W Chisholm St, Alpena, MI 49707-1401 Ph: (888) 356-7151 |
James Weeks, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 1501 W Chisholm St, Alpena, MI 49707 Phone: 989-356-7390 | |
Dr. Ben Edward Eggleston, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 704 W Washington Ave, Alpena, MI 49707 Phone: 952-595-1100 Fax: 612-294-4903 | |
Dr. Charles S Spann, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1501 W Chisholm St, Alpena, MI 49707 Phone: 989-356-7390 | |
Kyle Clifford Cuneo, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1501 West Chisholm St, Alpena, MI 49707 Phone: 888-356-7151 | |
Julie M Forstner, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1501 W Chisholm St, Alpena, MI 49707 Phone: 989-356-7353 |