Lisa Diane Roberts, NP is a medicare enrolled "Nurse Practitioner - Family" in Breckenridge, Colorado. Her current practice location is
85 Revett Dr, Breckenridge, Colorado. You can reach out to her office (for appointments etc.) via phone at
(239) 258-8191.
Lisa Diane Roberts is licensed to practice in Colorado (license number C-APN.0003225-C-NP) 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 1336804277.
Provider's Profile
| Full Name | Lisa Diane Roberts |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 85 Revett Dr, Breckenridge, Colorado |
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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: 1336804277
- Provider Enumeration Date: 11/04/2021
- Last Update Date: 08/02/2023
Medicare PECOS Information:
- PECOS PAC ID: 2567825375
- Enrollment ID: I20230828000615
Medical Identifiers
Medical identifiers for Lisa Diane Roberts such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1336804277 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | C-APN.0003225-C-NP (Colorado) | Primary |
| 363L00000X | Nurse Practitioner | 10008992 (Oregon) | Secondary |
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. Lisa Diane Roberts allows following entities to bill medicare on her behalf.
| Entity Name | Peacehealth |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1982774378
PECOS PAC ID: 4587573001
Enrollment ID: O20031215000598 |
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| Entity Name | Peacehealth |
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| Entity Type | Part A Provider - Critical Access Hospital |
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| Entity Identifiers | NPI Number: 1578552402
PECOS PAC ID: 4587573001
Enrollment ID: O20061104000179 |
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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. Lisa Diane Roberts 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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Lisa Diane Roberts, NP
85 Revett Dr,
Breckenridge, CO 80424-8956
Ph: () - | Lisa Diane Roberts, NP
85 Revett Dr,
Breckenridge, CO 80424-8956
Ph: (239) 258-8191 |
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