Laura E Dietrich-lake, FNP-C - Medicare Nurse Practitioner in Phoenix, AZ

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Laura E Dietrich-lake, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Phoenix, Arizona. She graduated from nursing school in 2017 and has 7 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice District Medical Group Inc and her current practice location is 4707 N 12th St, Phoenix, Arizona. You can reach out to her office (for appointments etc.) via phone at (602) 344-2506.

Laura E Dietrich-lake is licensed to practice in Arizona (license number AP10869) 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 1639684046.

Contact Information

Laura E Dietrich-lake, FNP-C
4707 N 12th St,
Phoenix, AZ 85014-4009
(602) 344-2506
(602) 247-9506

Map and Direction




Provider's Profile

Full NameLaura E Dietrich-lake
GenderFemale
SpecialityNurse Practitioner
Experience7 Years
Location4707 N 12th St, Phoenix, Arizona
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Laura E Dietrich-lake graduated from nursing school in 2017
  NPI Data:
  • NPI Number: 1639684046
  • Provider Enumeration Date: 12/07/2017
  • Last Update Date: 03/17/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 8325300551
  • Enrollment ID: I20180327002419

Medical Identifiers

Medical identifiers for Laura E Dietrich-lake such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1639684046NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family AP10869 (Arizona)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
District Medical Group Inc7315086691362

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. Laura E Dietrich-lake allows following entities to bill medicare on her behalf.
Entity NameMaricopa County Special Health Care District
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073576740
PECOS PAC ID: 4688583651
Enrollment ID: O20031204000823
Entity NameJewish Family & Childrens Service
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023174455
PECOS PAC ID: 9234028671
Enrollment ID: O20040312001009
Entity NameDistrict Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1336472448
PECOS PAC ID: 7315086691
Enrollment ID: O20091125000583
Entity NamePartners In Recovery Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1922232925
PECOS PAC ID: 9638212301
Enrollment ID: O20100203000179
Entity NameKmtrask Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1518413962
PECOS PAC ID: 8921386483
Enrollment ID: O20171212002971

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. Laura E Dietrich-lake 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 AddressPractice Location Address
Laura E Dietrich-lake, FNP-C
2929 E Thomas Rd,
Phoenix, AZ 85016-8034

Ph: (602) 470-5000		Laura E Dietrich-lake, FNP-C
4707 N 12th St,
Phoenix, AZ 85014-4009

Ph: (602) 344-2506

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.