Ms Susan Blake Lyons, PA is a medicare enrolled "Physician Assistant - Medical" in Le Roy, New York. Her current practice location is
3 Tountas Ave, Suite 3, Le Roy, New York. You can reach out to her office (for appointments etc.) via phone at
(585) 767-4220.
Ms Susan Blake Lyons is licensed to practice in New York (license number 004828) 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 1487681243.
Provider's Profile
| Full Name | Ms Susan Blake Lyons |
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| Gender | Female |
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| Speciality | Physician Assistant - Medical |
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| Location | 3 Tountas Ave, Le Roy, New York |
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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: 1487681243
- Provider Enumeration Date: 06/27/2006
- Last Update Date: 09/23/2011
Medicare PECOS Information:
- PECOS PAC ID: 9931008323
- Enrollment ID: I20040105000699
Medical Identifiers
Medical identifiers for Ms Susan Blake Lyons such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1487681243 | NPI | - | NPPES |
| 02395962 | Medicaid | NY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363AM0700X | Physician Assistant - Medical | 004828 (New York) | Primary |
| 363AM0700X | Physician Assistant - Medical | (* (Not Available)) | Secondary |
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. Ms Susan Blake Lyons 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 |
|---|
Ms Susan Blake Lyons, PA
3 Tountas Ave, Suite 3,
Le Roy, NY 14482-1368
Ph: (585) 767-4220 | Ms Susan Blake Lyons, PA
3 Tountas Ave, Suite 3,
Le Roy, NY 14482-1368
Ph: (585) 767-4220 |
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