| Ms Tara Lynn Lassila, PA | |
|
500 Campus Dr, Hancock, MI 49930-1569 | |
| (906) 483-1000 | |
| (906) 483-1147 |
| Full Name | Ms Tara Lynn Lassila |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 10 Years |
| Location | 500 Campus Dr, Hancock, Michigan |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356527063 | NPI | - | NPPES |
| 0C16002 | Other | MI | MEDICARE GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 5601007849 (Michigan) | Primary |
| 133V00000X | Dietitian, Registered | TL955786 (NU) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Up Health System Portage | Hancock, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Portage Physician Practices Inc | 6103053509 | 56 |
| Entity Name | Portage Physician Practices Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225461684 PECOS PAC ID: 6103053509 Enrollment ID: O20131210001058 |
| Entity Name | Portage Hospital LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245667229 PECOS PAC ID: 1951538883 Enrollment ID: O20140224000087 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Tara Lynn Lassila, PA 500 Campus Dr, Hancock, MI 49930-1569 Ph: (906) 483-1000 | Ms Tara Lynn Lassila, PA 500 Campus Dr, Hancock, MI 49930-1569 Ph: (906) 483-1000 |
Mercedes A Maki, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 500 Campus Dr, Hancock, MI 49930 Phone: 906-483-1000 Fax: 906-483-1103 |
Ms. Courtney Holly Smith, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 500 Campus Dr, Emergency Department, Hancock, MI 49930 Phone: 906-483-1000 |
Kathryn E Kass, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 500 Campus Dr, Hancock, MI 49930 Phone: 906-483-1060 Fax: 906-372-3230 |
Mr. Guy Pellegrini, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 500 Campus Dr, Hancock, MI 49930 Phone: 906-483-1000 |
Jesse R Primeau, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 500 Campus Dr, Hancock, MI 49930 Phone: 906-483-1777 |
Whitney J Brey, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 500 Campus Dr, Suite 2, Hancock, MI 49930 Phone: 906-483-1060 Fax: 906-372-3230 |
Ms. Megan M Brueggeman, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 500 Campus Drive, Suite 1, Hancock, MI 49930 Phone: 906-483-1040 Fax: 906-483-1270 |