Dr Karen Michelle Custodio, DO is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Lebanon, New Hampshire. Her current practice location is
1 Medical Center Dr, Lebanon, New Hampshire. You can reach out to her office (for appointments etc.) via phone at
(603) 650-5000.
Dr Karen Michelle Custodio is licensed to practice in New Hampshire (license number R4289) 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 1033734447.
Physician's Profile
Full Name | Dr Karen Michelle Custodio |
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Gender | Female |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 1 Medical Center Dr, Lebanon, New Hampshire |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1033734447
- Provider Enumeration Date: 06/11/2020
- Last Update Date: 07/11/2024
Medicare PECOS Information:
- PECOS PAC ID: 2769928522
- Enrollment ID: I20240729002452
Medical Identifiers
Medical identifiers for Dr Karen Michelle Custodio such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1033734447 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207P00000X | Emergency Medicine | OT019969 (Pennsylvania) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | R4289 (New Hampshire) | Primary |
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. Dr Karen Michelle Custodio 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 |
Dr Karen Michelle Custodio, DO 1 Medical Center Dr, Lebanon, NH 03756-0001 Ph: () - | Dr Karen Michelle Custodio, DO 1 Medical Center Dr, Lebanon, NH 03756-1000 Ph: (603) 650-5000 |
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