Mrs Lisa Nicole Odom, in Coeur D Alene, ID

Mrs Lisa Nicole Odom, is a medicare enrolled "Pediatrics" physician in Coeur D Alene, Idaho. Her current practice location is 1090 W Park Pl, Coeur D Alene, Idaho. You can reach out to her office (for appointments etc.) via phone at (208) 215-2005.

Mrs Lisa Nicole Odom is licensed to practice in Idaho (license number M-13382) 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 1598007668.

Contact Information

	Mrs Lisa Nicole Odom,
	1090 W Park Pl, Coeur D Alene, ID 83814-2785
	(208) 215-2005
	(844) 807-3782

Map and Direction

Physician's Profile

Full Name	Mrs Lisa Nicole Odom
Gender	Female
Speciality	Pediatrics
Location	1090 W Park Pl, Coeur D Alene, Idaho
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1598007668
Provider Enumeration Date: 03/26/2013
Last Update Date: 08/25/2021

Medicare PECOS Information:

PECOS PAC ID: 5890082804
Enrollment ID: I20160919002487

Medical Identifiers

Medical identifiers for Mrs Lisa Nicole Odom such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1598007668	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	M-13382 (Idaho)	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. Mrs Lisa Nicole Odom allows following entities to bill medicare on her behalf.

Entity Name	Kootenai Health, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1235288655 PECOS PAC ID: 4789641598 Enrollment ID: O20041214000230

Entity Name	Dirne Health Centers, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285686477 PECOS PAC ID: 2466353354 Enrollment ID: O20050303001041

Entity Name	Kootenai Health Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1174661151 PECOS PAC ID: 1355792276 Enrollment ID: O20240111003252

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. Mrs Lisa Nicole Odom 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
Mrs Lisa Nicole Odom, Po Box 1387, Hayden, ID 83835-1387 Ph: (208) 415-0299	Mrs Lisa Nicole Odom, 1090 W Park Pl, Coeur D Alene, ID 83814-2785 Ph: (208) 215-2005

Reviews and Comments

Pediatrics Doctors in Coeur D Alene, ID

Dr. Thomas R Rau, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814 Phone: 208-667-0585 Fax: 208-667-0876
Terence Earl Neff, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814 Phone: 208-667-0585 Fax: 208-667-0876
Dr. Brook Yuknis Lang, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-625-5185 Fax: 208-625-5892
Dr. Mary Jo Shaw, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814 Phone: 208-667-0585 Fax: 208-667-0876
Dr. Beth Ann Martin, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814 Phone: 208-667-0585 Fax: 208-667-0876
Dr. Cheri Kathleen Savage, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 700 W Ironwood Dr, Suite 155, Coeur D Alene, ID 83814 Phone: 208-667-0585 Fax: 208-667-0876
Dr. Rene Chalom, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-625-5930 Fax: 208-625-5931

Mrs Lisa Nicole Odom, - Medicare Pediatrics in Coeur D Alene, ID