Mr Louis Lee Mizell Jr Jr, MD is a medicare enrolled "Specialist" physician in Draper, Utah. His current practice location is
74 E Kimballs Ln Ste 330, Draper, Utah. You can reach out to his office (for appointments etc.) via phone at
(801) 545-8363.
Mr Louis Lee Mizell Jr Jr is licensed to practice in Utah (license number 82-168364-1205) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1851396964.
Physician's Profile
Full Name | Mr Louis Lee Mizell Jr Jr |
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Gender | Male |
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Speciality | Specialist |
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Location | 74 E Kimballs Ln Ste 330, Draper, Utah |
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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: 1851396964
- Provider Enumeration Date: 06/15/2005
- Last Update Date: 03/21/2019
Medicare PECOS Information:
- PECOS PAC ID: 3375889728
- Enrollment ID: I20211122002821
Medical Identifiers
Medical identifiers for Mr Louis Lee Mizell Jr Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1851396964 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2080P0206X | Pediatrics - Pediatric Gastroenterology | 168364-1205 (Utah) | Secondary |
174400000X | Specialist | 82-168364-1205 (Utah) | 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. Mr Louis Lee Mizell Jr Jr allows following entities to bill medicare on his behalf.
Entity Name | Pediatrix Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1730265919 PECOS PAC ID: 2567634587 Enrollment ID: O20190619000643 |
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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. Mr Louis Lee Mizell Jr Jr 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 |
Mr Louis Lee Mizell Jr Jr, MD 5770 So 250 E, Suite 330, Murray, UT 84107 Ph: (801) 314-4455 | Mr Louis Lee Mizell Jr Jr, MD 74 E Kimballs Ln Ste 330, Draper, UT 84020-5006 Ph: (801) 545-8363 |
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