Ms Lisa S Rose, FNP-C is a medicare enrolled "Nurse Practitioner - Primary Care" in Dubois, Wyoming. Her current practice location is
5647 Us Highway 26, Dubois, Wyoming. You can reach out to her office (for appointments etc.) via phone at
(307) 455-2516.
Ms Lisa S Rose is licensed to practice in Wyoming (license number 22672.1509) 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 1659734390.
Provider's Profile
| Full Name | Ms Lisa S Rose |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Primary Care |
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| Location | 5647 Us Highway 26, Dubois, Wyoming |
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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: 1659734390
- Provider Enumeration Date: 03/31/2016
- Last Update Date: 03/22/2022
Medicare PECOS Information:
- PECOS PAC ID: 3072893585
- Enrollment ID: I20161129000844
Medical Identifiers
Medical identifiers for Ms Lisa S Rose such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1659734390 | NPI | - | NPPES |
| 144824200 | Medicaid | WY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LP2300X | Nurse Practitioner - Primary Care | 22672.1509 (Wyoming) | 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. Ms Lisa S Rose allows following entities to bill medicare on her behalf.
| Entity Name | Community Health Center Of Central Wyoming Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1447480561
PECOS PAC ID: 3375454705
Enrollment ID: O20031105000279 |
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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. Ms Lisa S Rose 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 |
|---|
Ms Lisa S Rose, FNP-C
5000 Blackmore Rd,
Casper, WY 82609-3345
Ph: (307) 233-6000 | Ms Lisa S Rose, FNP-C
5647 Us Highway 26,
Dubois, WY 82513-9607
Ph: (307) 455-2516 |
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