Lisa Friebohle, is a medicare enrolled "Nurse Practitioner" in Peoria Heights, Illinois. She graduated from nursing school in 2014 and has 10 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Proctor Health Systems and her current practice location is
1120 E War Memorial Dr, Peoria Heights, Illinois. You can reach out to her office (for appointments etc.) via phone at
(309) 685-4411.
Lisa Friebohle is licensed to practice in Illinois (license number 209-012200) 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 1629466743.
Provider's Profile
| Full Name | Lisa Friebohle |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 10 Years |
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| Location | 1120 E War Memorial Dr, Peoria Heights, Illinois |
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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:
- Lisa Friebohle graduated from nursing school in 2014
NPI Data:
- NPI Number: 1629466743
- Provider Enumeration Date: 12/23/2014
- Last Update Date: 12/23/2014
Medicare PECOS Information:
- PECOS PAC ID: 5799001624
- Enrollment ID: I20150311001672
Medical Identifiers
Medical identifiers for Lisa Friebohle such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1629466743 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | 209-012200 (Illinois) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Proctor Health Systems | 3476440173 | 124 |
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 Friebohle allows following entities to bill medicare on her behalf.
| Entity Name | Proctor Health Systems |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1134173917
PECOS PAC ID: 3476440173
Enrollment ID: O20040227000906 |
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| Entity Name | Belcrest Services Ltd |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1245275312
PECOS PAC ID: 9335037217
Enrollment ID: O20040310001103 |
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| Entity Name | Methodist Medical Center Of Illinois |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1184670663
PECOS PAC ID: 1355259714
Enrollment ID: O20040315000196 |
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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 Friebohle 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 Friebohle,
1120 E War Memorial Dr,
Peoria Heights, IL 61616-7757
Ph: (309) 685-4411 | Lisa Friebohle,
1120 E War Memorial Dr,
Peoria Heights, IL 61616-7757
Ph: (309) 685-4411 |
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