Mrs Leslie Ann Lake, FNP-BC in Berlin, MD - Medicare Nurse Practitioner

Mrs Leslie Ann Lake, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Berlin, Maryland. Her current practice location is 9858 Shore Break Ln Apt 311, Berlin, Maryland. You can reach out to her office (for appointments etc.) via phone at (912) 689-9322.

Mrs Leslie Ann Lake is licensed to practice in Maryland (license number R155906) 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 1134877525.

Contact Information

	Mrs Leslie Ann Lake, FNP-BC
	9858 Shore Break Ln Apt 311, Berlin, MD 21811-3028
	(912) 689-9322
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Leslie Ann Lake
Gender	Female
Speciality	Nurse Practitioner - Family
Location	9858 Shore Break Ln Apt 311, Berlin, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1134877525
Provider Enumeration Date: 03/15/2022
Last Update Date: 03/15/2022

Medicare PECOS Information:

PECOS PAC ID: 2062896764
Enrollment ID: I20220830001534

Medical Identifiers

Medical identifiers for Mrs Leslie Ann Lake such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1134877525	NPI	-	NPPES
R155906	Other	MD	LICENSURE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	R155906 (Maryland)	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 Leslie Ann Lake allows following entities to bill medicare on her behalf.

Entity Name	Psychogeriatric Services Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1588689483 PECOS PAC ID: 6002719226 Enrollment ID: O20040128000532

Entity Name	Acute Injury And Illness Centers Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1548330343 PECOS PAC ID: 3870687536 Enrollment ID: O20070926000197

Entity Name	Access Primary Care Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1033550496 PECOS PAC ID: 0345479986 Enrollment ID: O20140131001037

Entity Name	75th Street Injury & Illness Center Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1245740109 PECOS PAC ID: 3375806540 Enrollment ID: O20180423000705

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 Leslie Ann Lake 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 Leslie Ann Lake, FNP-BC 9858 Shore Break Ln Apt 311, Berlin, MD 21811-3028 Ph: (912) 689-9322	Mrs Leslie Ann Lake, FNP-BC 9858 Shore Break Ln Apt 311, Berlin, MD 21811-3028 Ph: (912) 689-9322

Reviews and Comments

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Dr. Jordan Pearson Braniff, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 11101 Cathage Rd, Berlin, MD 21811 Phone: 410-912-6104
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Mrs Leslie Ann Lake, FNP-BC - Medicare Nurse Practitioner in Berlin, MD