Rachel Lackow, in Salt Lake City, UT - Medicare Nurse Practitioner

Rachel Lackow, is a medicare enrolled "Nurse Practitioner - Family" in Salt Lake City, Utah. Her current practice location is 425 E Bishop Federal Ln, Salt Lake City, Utah. You can reach out to her office (for appointments etc.) via phone at (801) 468-6807.

Rachel Lackow is licensed to practice in Utah (license number 11932179-4405) 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 1396515342.

Contact Information

	Rachel Lackow,
	425 E Bishop Federal Ln, Salt Lake City, UT 84115-2362
	(801) 468-6807
	Not Available

Map and Direction

Provider's Profile

Full Name	Rachel Lackow
Gender	Female
Speciality	Nurse Practitioner - Family
Location	425 E Bishop Federal Ln, Salt Lake City, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1396515342
Provider Enumeration Date: 01/02/2024
Last Update Date: 01/02/2024

Medicare PECOS Information:

PECOS PAC ID: 9335585827
Enrollment ID: I20240306003455

Medical Identifiers

Medical identifiers for Rachel Lackow such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1396515342	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	11932179-4405 (Utah)	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. Rachel Lackow allows following entities to bill medicare on her behalf.

Entity Name	Gadzoom Health Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1770187163 PECOS PAC ID: 3476954793 Enrollment ID: O20210624000883

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. Rachel Lackow 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
Rachel Lackow, 1192 E Draper Pkwy, Draper, UT 84020-9356 Ph: () -	Rachel Lackow, 425 E Bishop Federal Ln, Salt Lake City, UT 84115-2362 Ph: (801) 468-6807

Reviews and Comments

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Rachel Lackow, - Medicare Nurse Practitioner in Salt Lake City, UT