Spencer Lee Lake, in Bountiful, UT - Medicare Nurse Practitioner

Spencer Lee Lake, is a medicare enrolled "Nurse Practitioner - Family" in Bountiful, Utah. His current practice location is 557 W 2600 S, Bountiful, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 298-9155.

Spencer Lee Lake is licensed to practice in Utah (license number 6342236-4405) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1932869377.

Contact Information

	Spencer Lee Lake,
	557 W 2600 S, Bountiful, UT 84010-7717
	(801) 298-9155
	(801) 298-9156

Map and Direction

Provider's Profile

Full Name	Spencer Lee Lake
Gender	Male
Speciality	Nurse Practitioner - Family
Location	557 W 2600 S, Bountiful, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1932869377
Provider Enumeration Date: 12/27/2021
Last Update Date: 12/27/2021

Medicare PECOS Information:

PECOS PAC ID: 0446642763
Enrollment ID: I20220119001144

Medical Identifiers

Medical identifiers for Spencer Lee Lake such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1932869377	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	6342236-4405 (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. Spencer Lee Lake allows following entities to bill medicare on his behalf.

Entity Name	Joshua Oaks
Entity Type	Practitioner - Internal Medicine
Entity Identifiers	NPI Number: 1205221405 PECOS PAC ID: 0244594729 Enrollment ID: I20180509001485

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. Spencer Lee Lake 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
Spencer Lee Lake, 557 W 2600 S, Bountiful, UT 84010-7717 Ph: (801) 298-9155	Spencer Lee Lake, 557 W 2600 S, Bountiful, UT 84010-7717 Ph: (801) 298-9155

Reviews and Comments

Nurse Practitioner Nurses in Bountiful, UT

Kenzlee Wooden, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 845 S Main St Ste A7, Bountiful, UT 84010 Phone: 801-298-0903
Daelyn Tasha Clawson, RN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 390 N Main St, Bountiful, UT 84010 Phone: 801-397-6670
Miss Lauren Lightfield, AGACNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 458 N 500 W, Bountiful, UT 84010 Phone: 801-292-9355 Fax: 801-296-8050
Sarah Elizabeth Mcmillin, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 111 W 3100 S, Bountiful, UT 84010 Phone: 801-668-7479
Mistie Sue Manning, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1551 Renaissance Towne Dr Ste 370, Bountiful, UT 84010 Phone: 801-747-7244
Dr. Rachel Starr Wagner Pollard, DNP, APRN, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 320 W 500 S Ste 210, Bountiful, UT 84010 Phone: 801-797-9121
Janice M Trump, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 630 Medical Dr, Bountiful, UT 84010 Phone: 801-299-3781

Spencer Lee Lake, - Medicare Nurse Practitioner in Bountiful, UT