Tristan Roman Lubina, in Salt Lake City, UT - Medicare Nurse Practitioner

Tristan Roman Lubina, is a medicare enrolled "Nurse Practitioner" in Salt Lake City, Utah. His current practice location is 1501 University Vlg, Salt Lake City, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 587-7000.

Tristan Roman Lubina is licensed to practice in Utah (license number 12345127-4405) 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 1699360065.

Contact Information

	Tristan Roman Lubina,
	1501 University Vlg, Salt Lake City, UT 84108-3522
	(801) 587-7000
	Not Available

Map and Direction

Provider's Profile

Full Name	Tristan Roman Lubina
Gender	Male
Speciality	Nurse Practitioner
Location	1501 University Vlg, 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: 1699360065
Provider Enumeration Date: 03/07/2021
Last Update Date: 07/29/2021

Medicare PECOS Information:

PECOS PAC ID: 7315341526
Enrollment ID: I20210810003999

Medical Identifiers

Medical identifiers for Tristan Roman Lubina such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1699360065	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163WX0200X	Registered Nurse - Oncology	10670291-3102 (Utah)	Secondary
363L00000X	Nurse Practitioner	12345127-4405 (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. Tristan Roman Lubina allows following entities to bill medicare on his behalf.

Entity Name	Ma Bo Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1740461219 PECOS PAC ID: 1254399652 Enrollment ID: O20050103000257

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. Tristan Roman Lubina 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
Tristan Roman Lubina, 650 Round Valley Dr, Park City, UT 84060-7571 Ph: () -	Tristan Roman Lubina, 1501 University Vlg, Salt Lake City, UT 84108-3522 Ph: (801) 587-7000

Reviews and Comments

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Tristan Roman Lubina, - Medicare Nurse Practitioner in Salt Lake City, UT