Samara D Lazernick, MD is a medicare enrolled "Obstetrics & Gynecology" physician in Tooele, Utah. She went to Eastern Virginia Medical School and graduated in 2008 and has 16 years of diverse experience with area of expertise as Obstetrics/gynecology. She is a member of the group practice Tooele Clinic Corp and her current practice location is
196 E. 2000 N., Suite 104, Tooele, Utah. You can reach out to her office (for appointments etc.) via phone at
(435) 843-2576.
Samara D Lazernick is licensed to practice in Utah (license number 8229754-1205) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1659532307.
Physician's Profile
| Full Name | Samara D Lazernick |
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| Gender | Female |
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| Speciality | Obstetrics/gynecology |
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| Experience | 16 Years |
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| Location | 196 E. 2000 N., Tooele, Utah |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Samara D Lazernick attended and graduated from Eastern Virginia Medical School in 2008
NPI Data:
- NPI Number: 1659532307
- Provider Enumeration Date: 06/24/2008
- Last Update Date: 01/03/2019
Medicare PECOS Information:
- PECOS PAC ID: 6103073515
- Enrollment ID: I20120820000910
Medical Identifiers
Medical identifiers for Samara D Lazernick such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1659532307 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207V00000X | Obstetrics & Gynecology | 8229754-1205 (Utah) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Tooele Clinic Corp | 6800700873 | 40 |
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. Samara D Lazernick allows following entities to bill medicare on her behalf.
| Entity Name | Tooele Clinic Corp |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073512364
PECOS PAC ID: 6800700873
Enrollment ID: O20031113000800 |
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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. Samara D Lazernick 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 |
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Samara D Lazernick, MD
196 E. 2000 N., Suite 104,
Tooele, UT 84074
Ph: (435) 843-2576 | Samara D Lazernick, MD
196 E. 2000 N., Suite 104,
Tooele, UT 84074
Ph: (435) 843-2576 |
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