Kaitlin Raeleen Lange, PA-C is a medicare enrolled "Physician Assistant" physician in Eaton, Ohio. Her current practice location is
405 B Washington Jackson Road, Suite 108, Eaton, Ohio. You can reach out to her office (for appointments etc.) via phone at
(937) 456-8330.
Kaitlin Raeleen Lange is licensed to practice in Ohio (license number 50.007778RX) 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 1821712068.
Physician's Profile
Full Name | Kaitlin Raeleen Lange |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 405 B Washington Jackson Road, Eaton, Ohio |
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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: 1821712068
- Provider Enumeration Date: 09/30/2022
- Last Update Date: 04/19/2023
Medicare PECOS Information:
- PECOS PAC ID: 1456720168
- Enrollment ID: I20221219001866
Medical Identifiers
Medical identifiers for Kaitlin Raeleen Lange such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1821712068 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 50.007778RX (Ohio) | Secondary |
363A00000X | Physician Assistant | 50.007778RX (Ohio) | 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. Kaitlin Raeleen Lange 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 |
Kaitlin Raeleen Lange, PA-C 6845 Castlerock Trl Apt C, Dayton, OH 45459-6024 Ph: (937) 239-7818 | Kaitlin Raeleen Lange, PA-C 405 B Washington Jackson Road, Suite 108, Eaton, OH 45320 Ph: (937) 456-8330 |
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