Taylor Lackey, in Menasha, WI - Medicare Nurse Practitioner

Taylor Lackey, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Menasha, Wisconsin. Her current practice location is 1095 Midway Rd, Menasha, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 720-2300.

Taylor Lackey is licensed to practice in Wisconsin (license number 15030) 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 1083479539.

Contact Information

	Taylor Lackey,
	1095 Midway Rd, Menasha, WI 54952-1115
	(920) 720-2300
	Not Available

Map and Direction

Provider's Profile

Full Name	Taylor Lackey
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	1095 Midway Rd, Menasha, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1083479539
Provider Enumeration Date: 02/14/2024
Last Update Date: 02/14/2024

Medicare PECOS Information:

PECOS PAC ID: 1153768783
Enrollment ID: I20240319001797

Medical Identifiers

Medical identifiers for Taylor Lackey such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1083479539	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	15030 (Wisconsin)	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. Taylor Lackey allows following entities to bill medicare on her behalf.

Entity Name	Thedacare Incorporated
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1376656959 PECOS PAC ID: 1759294887 Enrollment ID: O20031106000088

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. Taylor Lackey 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
Taylor Lackey, 1095 Midway Rd, Menasha, WI 54952-1115 Ph: () -	Taylor Lackey, 1095 Midway Rd, Menasha, WI 54952-1115 Ph: (920) 720-2300

Reviews and Comments

Nurse Practitioner Nurses in Menasha, WI

Meghan Keyes, APNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1814 Appleton Rd, Menasha, WI 54952 Phone: 920-731-7445 Fax: 920-731-7459
Cheryl M Habeck, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1550 Midway Pl, Menasha, WI 54952 Phone: 920-727-8030
Stephanie Frances Samson, APNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2005 Midway Rd, Menasha, WI 54952 Phone: 920-832-8500
Lisa Kasperek, APNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1186 Appleton Rd, Menasha, WI 54952 Phone: 920-727-8733
Esther Melsha, APNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1814 Appleton Rd, Menasha, WI 54952 Phone: 920-931-1150
Barbara Farb, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2005 Midway Rd, Menasha, WI 54952 Phone: 920-832-8500 Fax: 920-993-2919

Taylor Lackey, - Medicare Nurse Practitioner in Menasha, WI