Lee Self, MD is a medicare enrolled "Obstetrics & Gynecology - Gynecology" physician in Emmett, Idaho. Her current practice location is
2020 S Johns Ave Ste B, Emmett, Idaho. You can reach out to her office (for appointments etc.) via phone at
(208) 425-7507.
Lee Self is licensed to practice in Idaho (license number M7844) 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 1639121361.
Physician's Profile
Full Name | Lee Self |
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Gender | Female |
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Speciality | Obstetrics & Gynecology - Gynecology |
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Location | 2020 S Johns Ave Ste B, Emmett, Idaho |
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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: 1639121361
- Provider Enumeration Date: 05/17/2006
- Last Update Date: 11/12/2023
Medicare PECOS Information:
- PECOS PAC ID: 5395657787
- Enrollment ID: I20031104000378
Medical Identifiers
Medical identifiers for Lee Self such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1639121361 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207V00000X | Obstetrics & Gynecology | M7844 (Idaho) | Secondary |
207VX0000X | Obstetrics & Gynecology - Obstetrics | M7844 (Idaho) | Secondary |
207VG0400X | Obstetrics & Gynecology - Gynecology | M7844 (Idaho) | 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. Lee Self 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 |
Lee Self, MD 23000 Sweet Ola Hwy, Ola, ID 83657-5027 Ph: (208) 880-4904 | Lee Self, MD 2020 S Johns Ave Ste B, Emmett, ID 83617-9410 Ph: (208) 425-7507 |
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