Ms Beatrice Lee Godbouldt, PA-C is a medicare enrolled "Physician Assistant - Medical" physician in Las Vegas, Nevada. Her current practice location is
821 N Nellis Blvd, Las Vegas, Nevada. You can reach out to her office (for appointments etc.) via phone at
(702) 438-4003.
Ms Beatrice Lee Godbouldt is licensed to practice in Nevada (license number PA1710) 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 1457406241.
Physician's Profile
| Full Name | Ms Beatrice Lee Godbouldt |
|---|
| Gender | Female |
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| Speciality | Physician Assistant - Medical |
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| Location | 821 N Nellis Blvd, Las Vegas, Nevada |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1457406241
- Provider Enumeration Date: 01/24/2007
- Last Update Date: 03/17/2017
Medicare PECOS Information:
- PECOS PAC ID: 4082751235
- Enrollment ID: I20160428002317
Medical Identifiers
Medical identifiers for Ms Beatrice Lee Godbouldt such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1457406241 | NPI | - | NPPES |
| 1457406241 | Medicaid | NV | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | PA12936 (California) | Secondary |
| 363A00000X | Physician Assistant | PA12936 (California) | Secondary |
| 363AM0700X | Physician Assistant - Medical | PA1710 (Nevada) | 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. Ms Beatrice Lee Godbouldt 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 |
|---|
Ms Beatrice Lee Godbouldt, PA-C
Po Box 98978,
Las Vegas, NV 89193-8978
Ph: (702) 216-3346 | Ms Beatrice Lee Godbouldt, PA-C
821 N Nellis Blvd,
Las Vegas, NV 89110-5339
Ph: (702) 438-4003 |
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