Dawn Lisa Lidstone, FNP is a medicare enrolled "Nurse Practitioner - Family" in Canaan, Connecticut. Her current practice location is
76 Church St, Canaan, Connecticut. You can reach out to her office (for appointments etc.) via phone at
(860) 624-0731.
Dawn Lisa Lidstone is licensed to practice in Connecticut (license number 007744) 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 1922403542.
Provider's Profile
| Full Name | Dawn Lisa Lidstone |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 76 Church St, Canaan, Connecticut |
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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: 1922403542
- Provider Enumeration Date: 10/24/2014
- Last Update Date: 06/24/2020
Medicare PECOS Information:
- PECOS PAC ID: 1456678424
- Enrollment ID: I20150401000459
Medical Identifiers
Medical identifiers for Dawn Lisa Lidstone such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1922403542 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 163WG0000X | Registered Nurse - General Practice | 087663 (Connecticut) | Secondary |
| 163WG0000X | Registered Nurse - General Practice | 284722 (Massachusetts) | Secondary |
| 163WG0000X | Registered Nurse - General Practice | 679700-1 (New York) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 007744 (Connecticut) | 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. Dawn Lisa Lidstone allows following entities to bill medicare on her behalf.
| Entity Name | Sun River Health Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1568526838
PECOS PAC ID: 6608783568
Enrollment ID: O20040714000375 |
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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. Dawn Lisa Lidstone 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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Dawn Lisa Lidstone, FNP
Po Box 438,
Southfield, MA 01259-0438
Ph: (413) 854-1815 | Dawn Lisa Lidstone, FNP
76 Church St,
Canaan, CT 06018-2447
Ph: (860) 624-0731 |
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