| Blake Alan Luebbehusen, MSN, RN, NP-C | |
|
500 Arcade Ave Ste 210, Elkhart, IN 46514-2485 | |
| (574) 389-5656 | |
| Not Available |
| Full Name | Blake Alan Luebbehusen |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 5 Years |
| Location | 500 Arcade Ave Ste 210, Elkhart, Indiana |
| 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 |
|---|---|---|---|
| 1154925907 | NPI | - | NPPES |
| 236040357 | Other | IN | MEDICARE PTAN |
| 300045960 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 71010668A (Indiana) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Cleanslate Medical Group Of Indiana Llc | 4880963909 | 47 |
| Entity Name | Cleanslate Medical Group Of Indiana Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023464294 PECOS PAC ID: 4880963909 Enrollment ID: O20171023001515 |
| Mailing Address | Practice Location Address |
|---|---|
| Blake Alan Luebbehusen, MSN, RN, NP-C 710 N Niles Ave, South Bend, IN 46617-1924 Ph: (574) 647-1610 | Blake Alan Luebbehusen, MSN, RN, NP-C 500 Arcade Ave Ste 210, Elkhart, IN 46514-2485 Ph: (574) 389-5656 |
Elizabeth W Maina, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 236 Simpson Ave, Elkhart, IN 46516 Phone: 574-293-0052 | |
Ms. Cecilia Mumbi Maina, FNP Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 236 Simpson Ave, Elkhart, IN 46516 Phone: 574-293-0052 | |
Mr. Kenneth Francis Raderstorf Iii, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3301 County Road 6 E, Elkhart, IN 46514 Phone: 574-266-5342 Fax: 574-266-5847 | |
Rosemary J Eash, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1627 E Bristol St, Elkhart, IN 46514 Phone: 574-262-0313 Fax: 574-262-8163 | |
Lorraine Doris Swartzentruber, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 236 Simpson Ave, Elkhart, IN 46516 Phone: 574-293-0052 | |
Ashley Marie Brunt, NURSE PRA Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 500 Arcade Ave Ste 400, Elkhart, IN 46514 Phone: 574-522-2284 Fax: 574-522-3952 | |
Mrs. Catherine E Dos Santos, MSN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3421 S Main St, Elkhart, IN 46517 Phone: 574-295-7178 Fax: 574-295-8822 |