Lucille Hester Brongersma, OD in Santa Rosa, CA - Medicare Optometrist Provider

Lucille Hester Brongersma, OD is a medicare enrolled "Optometrist" provider in Santa Rosa, California. Her current practice location is 3925 Old Redwood Hwy, Santa Rosa, California. You can reach out to her office (for appointments etc.) via phone at (707) 566-5297.

Lucille Hester Brongersma is licensed to practice in California (license number 8200T) 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 1033266218.

Contact Information

	Lucille Hester Brongersma, OD
	3925 Old Redwood Hwy, Santa Rosa, CA 95403-1719
	(707) 566-5297
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Lucille Hester Brongersma
Gender	Female
Speciality	Optometrist
Location	3925 Old Redwood Hwy, Santa Rosa, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1033266218
Provider Enumeration Date: 01/03/2007
Last Update Date: 12/30/2021

Medicare PECOS Information:

PECOS PAC ID: 0749430510
Enrollment ID: I20121101000556

Medical Identifiers

Medical identifiers for Lucille Hester Brongersma such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1033266218	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
152W00000X	Optometrist	8200T (California)	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. Lucille Hester Brongersma allows following entities to bill medicare on her behalf.

Provider Name	Permanente Medical Group Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710

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. Lucille Hester Brongersma 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
Lucille Hester Brongersma, OD 4844 Glencannon St, Santa Rosa, CA 95405-7912 Ph: (707) 538-2482	Lucille Hester Brongersma, OD 3925 Old Redwood Hwy, Santa Rosa, CA 95403-1719 Ph: (707) 566-5297

Reviews and Comments

Optometrist in Santa Rosa, CA

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Lucille Hester Brongersma, OD - Medicare Optometrist in Santa Rosa, CA