Dr Lisa M Nicholson, MD - Medicare Obstetrics & Gynecology in Kirkland, WA

Dr Lisa M Nicholson, MD is a medicare enrolled "Obstetrics & Gynecology" physician in Kirkland, Washington. Her current practice location is 12040 Ne 128th St, Kirkland, Washington. You can reach out to her office (for appointments etc.) via phone at (425) 899-1000.

Dr Lisa M Nicholson is licensed to practice in Washington (license number MD61023448) 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 1689840399.

Contact Information

Dr Lisa M Nicholson, MD
12040 Ne 128th St,
Kirkland, WA 98034-3013
(425) 899-1000
Not Available



Physician's Profile

Full NameDr Lisa M Nicholson
GenderFemale
SpecialityObstetrics & Gynecology
Location12040 Ne 128th St, Kirkland, Washington
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1689840399
  • Provider Enumeration Date: 05/02/2008
  • Last Update Date: 12/09/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 8022360122
  • Enrollment ID: I20200117001808

Medical Identifiers

Medical identifiers for Dr Lisa M Nicholson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1689840399NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207V00000XObstetrics & Gynecology 04-41362 (Kansas)Secondary
207V00000XObstetrics & Gynecology 01068067A (Indiana)Secondary
207V00000XObstetrics & Gynecology MD61023448 (Washington)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. Dr Lisa M Nicholson allows following entities to bill medicare on her behalf.
Entity NameKing County Public Hospital District No 2
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1801986070
PECOS PAC ID: 7618880097
Enrollment ID: O20031111000557

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› Verified 3 days ago

Entity NameValley Medical Group-renton
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1619209574
PECOS PAC ID: 4183753965
Enrollment ID: O20100604000113

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Entity NameObhg Washington Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1962729525
PECOS PAC ID: 0345364642
Enrollment ID: O20100823001087

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› Verified 3 days ago

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. Dr Lisa M Nicholson 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 AddressPractice Location Address
Dr Lisa M Nicholson, MD
16931 Mount Olivet Rd,
Leavenworth, KS 66048-7530

Ph: (937) 248-9479
Dr Lisa M Nicholson, MD
12040 Ne 128th St,
Kirkland, WA 98034-3013

Ph: (425) 899-1000

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› Verified 3 days ago


Obstetrics & Gynecology Doctors in Kirkland, WA

Dr. Ronald Duane Beesley, M.D.
Obstetrics & Gynecology
Medicare: Medicare Enrolled
Practice Location: 12039 Ne 128th St Ste 110, Kirkland, WA 98034
Phone: 425-822-7662    Fax: 425-822-0172
Dr. Jean R Dydell, M.D.
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 12303 Ne 130th Ln Ste 450, Kirkland, WA 98034
Phone: 425-899-5000    Fax: 425-899-5006
Melissa Heather Tran, MD
Obstetrics & Gynecology
Medicare: Not Enrolled in Medicare
Practice Location: 12910 Totem Lake Blvd Ne Ste 102, Kirkland, WA 98034
Phone: 425-899-4455    
Christina Tun, MD
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 12303 Ne 130th Lane Suite #230, Kirkland, WA 98034
Phone: 425-899-5000    Fax: 425-899-5006
Dr. John Paul Isbell, M.D
Obstetrics & Gynecology
Medicare: Medicare Enrolled
Practice Location: 12303 Ne 130th Ln, Ste 400, Kirkland, WA 98034
Phone: 425-899-4692    Fax: 425-899-4693
Dr. Susan E Rutherford, M.D.
Obstetrics & Gynecology
Medicare: Not Enrolled in Medicare
Practice Location: 12040 Ne 128th St, Kirkland, WA 98034
Phone: 425-899-4719    Fax: 425-899-3481
Guoli Johnston, MD
Obstetrics & Gynecology
Medicare: Accepting Medicare Assignments
Practice Location: 12910 Totem Lake Blvd Ne Ste 102, Kirkland, WA 98034
Phone: 425-899-4455    Fax: 425-899-4434

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