Mrs Lisa Ruth Mclean, PA-C is a medicare enrolled "Physician Assistant - Medical" physician in Allen Park, Michigan. Her current practice location is
17500 Federal Dr Ste 750, Allen Park, Michigan. You can reach out to her office (for appointments etc.) via phone at
(313) 982-1370.
Mrs Lisa Ruth Mclean is licensed to practice in Michigan (license number 5601008938) 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 1114476140.
Physician's Profile
Full Name | Mrs Lisa Ruth Mclean |
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Gender | Female |
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Speciality | Physician Assistant - Medical |
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Location | 17500 Federal Dr Ste 750, Allen Park, Michigan |
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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: 1114476140
- Provider Enumeration Date: 10/03/2016
- Last Update Date: 04/29/2021
Medicare PECOS Information:
- PECOS PAC ID: 1153607395
- Enrollment ID: I20170424001796
Medical Identifiers
Medical identifiers for Mrs Lisa Ruth Mclean such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1114476140 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2083X0100X | Preventive Medicine - Occupational Medicine | 5601008938 (Michigan) | Secondary |
363AM0700X | Physician Assistant - Medical | PA53731 (California) | Secondary |
363AM0700X | Physician Assistant - Medical | 5601008938 (Michigan) | 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. Mrs Lisa Ruth Mclean 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 |
Mrs Lisa Ruth Mclean, PA-C 17500 Federal Dr Ste 750, Allen Park, MI 48101-3656 Ph: (313) 982-1370 | Mrs Lisa Ruth Mclean, PA-C 17500 Federal Dr Ste 750, Allen Park, MI 48101-3656 Ph: (313) 982-1370 |
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