Lesley S Dishaw, PAC is a medicare enrolled "Physician Assistant" in Florence, Wisconsin. She graduated from nursing school in 2000 and has 24 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Bellin Memorial Hospital Inc and her current practice location is
1010 Olive Ave, Florence, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(800) 380-7411.
Lesley S Dishaw is licensed to practice in Michigan (license number 5601003358) 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 1740262856.
Provider's Profile
| Full Name | Lesley S Dishaw |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Experience | 24 Years |
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| Location | 1010 Olive Ave, Florence, Wisconsin |
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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:
- Lesley S Dishaw graduated from nursing school in 2000
NPI Data:
- NPI Number: 1740262856
- Provider Enumeration Date: 11/15/2005
- Last Update Date: 09/30/2020
Medicare PECOS Information:
- PECOS PAC ID: 6204917768
- Enrollment ID: I20080123000014
Medical Identifiers
Medical identifiers for Lesley S Dishaw such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1740262856 | NPI | - | NPPES |
| 970028140 | Other | MI | RR MEDICARE |
| 0852210330 | Other | MI | BCBS MI |
| 41927000 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 1236023 (Wisconsin) | Secondary |
| 363A00000X | Physician Assistant | 5601003358 (Michigan) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Bellin Memorial Hospital Inc | 8820900749 | 533 |
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. Lesley S Dishaw 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 |
|---|
Lesley S Dishaw, PAC
Po Box 22487,
Green Bay, WI 54305-2487
Ph: (920) 445-7226 | Lesley S Dishaw, PAC
1010 Olive Ave,
Florence, WI 54121-0380
Ph: (800) 380-7411 |
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