Lisa M Dedomenico, CRNP, MSN in Kingston, PA - Medicare Nurse Practitioner

Lisa M Dedomenico, CRNP, MSN is a medicare enrolled "Nurse Practitioner" in Kingston, Pennsylvania. Her current practice location is 190 Welles St, Kingston, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at (570) 714-1099.

Lisa M Dedomenico is licensed to practice in Pennsylvania (license number TP001029G) 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 1184657751.

Contact Information

	Lisa M Dedomenico, CRNP, MSN
	190 Welles St, Kingston, PA 18704-4968
	(570) 714-1099
	(570) 714-1116

Map and Direction

Provider's Profile

Full Name	Lisa M Dedomenico
Gender	Female
Speciality	Nurse Practitioner
Location	190 Welles St, Kingston, Pennsylvania
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1184657751
Provider Enumeration Date: 07/08/2006
Last Update Date: 07/30/2020

Medicare PECOS Information:

PECOS PAC ID: 5294633236
Enrollment ID: I20031229000592

Medical Identifiers

Medical identifiers for Lisa M Dedomenico such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1184657751	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LX0001X	Nurse Practitioner - Obstetrics & Gynecology	TP001029G (Pennsylvania)	Secondary
363L00000X	Nurse Practitioner	TP001029G (Pennsylvania)	Primary

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 M Dedomenico allows following entities to bill medicare on her behalf.

Entity Name	Geisinger Clinic
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366493868 PECOS PAC ID: 5395657001 Enrollment ID: O20040130000518

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 M Dedomenico 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
Lisa M Dedomenico, CRNP, MSN 100 N Academy Ave, Danville, PA 17822-4903 Ph: (570) 271-6144	Lisa M Dedomenico, CRNP, MSN 190 Welles St, Kingston, PA 18704-4968 Ph: (570) 714-1099

Reviews and Comments

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Catherine Champi, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 610 Wyoming Ave, Suite 1, Kingston, PA 18704 Phone: 570-288-5441 Fax: 570-288-9613
Brenda Miller Tocket, PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 79 S Gates Ave, Kingston, PA 18704 Phone: 570-406-7350

Lisa M Dedomenico, CRNP, MSN - Medicare Nurse Practitioner in Kingston, PA