Mrs Jenaye Laron Lisbon, FNP in Detroit, MI - Medicare Nurse Practitioner

Mrs Jenaye Laron Lisbon, FNP is a medicare enrolled "Nurse Practitioner - Primary Care" in Detroit, Michigan. Her current practice location is 7700 Second Avenue, Wellness Plan, Detroit, Michigan. You can reach out to her office (for appointments etc.) via phone at (313) 202-8500.

Mrs Jenaye Laron Lisbon is licensed to practice in Michigan (license number 4704238010) 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 1265980023.

Contact Information

	Mrs Jenaye Laron Lisbon, FNP
	7700 Second Avenue, Wellness Plan, Detroit, MI 48202
	(313) 202-8500
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Jenaye Laron Lisbon
Gender	Female
Speciality	Nurse Practitioner - Primary Care
Location	7700 Second Avenue, Detroit, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1265980023
Provider Enumeration Date: 09/21/2016
Last Update Date: 06/11/2018

Medicare PECOS Information:

PECOS PAC ID: 7012299647
Enrollment ID: I20170116000703

Medical Identifiers

Medical identifiers for Mrs Jenaye Laron Lisbon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1265980023	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP2300X	Nurse Practitioner - Primary Care	4704238010 (Michigan)	Primary
363LF0000X	Nurse Practitioner - Family	4704238010 (Michigan)	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. Mrs Jenaye Laron Lisbon allows following entities to bill medicare on her behalf.

Entity Name	Hegira Health Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1184684979 PECOS PAC ID: 3173429560 Enrollment ID: O20031208000753

Entity Name	The Wellness Plan Medical Centers
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043373244 PECOS PAC ID: 1052380201 Enrollment ID: O20040925000098

Entity Name	Molina Care Connections Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1407243223 PECOS PAC ID: 5799062881 Enrollment ID: O20180320001095

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. Mrs Jenaye Laron Lisbon 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
Mrs Jenaye Laron Lisbon, FNP 7442 Rutherford St, Detroit, MI 48228-3652 Ph: (313) 623-1541	Mrs Jenaye Laron Lisbon, FNP 7700 Second Avenue, Wellness Plan, Detroit, MI 48202 Ph: (313) 202-8500

Reviews and Comments

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Mrs Jenaye Laron Lisbon, FNP - Medicare Nurse Practitioner in Detroit, MI