Mr Derek C Lish, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Brigham City, UT

Mr Derek C Lish, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Brigham City, Utah. He graduated from nursing school in 2009 and has 15 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Brigham Anesthesia, Llc, Nph Anesthesia Of Utah Llc and his current practice location is 950 Medical Dr, Brigham City, Utah. You can reach out to his office (for appointments etc.) via phone at (435) 734-9471.

Mr Derek C Lish is licensed to practice in Idaho (license number TEMP RNA 19861) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1699914044.

Contact Information

Mr Derek C Lish, CRNA
950 Medical Dr,
Brigham City, UT 84302-4724
(435) 734-9471
Not Available



Provider's Profile

Full NameMr Derek C Lish
GenderMale
SpecialityCertified Registered Nurse Anesthetist (crna)
Experience15 Years
Location950 Medical Dr, Brigham City, Utah
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mr Derek C Lish graduated from nursing school in 2009
  NPI Data:
  • NPI Number: 1699914044
  • Provider Enumeration Date: 02/09/2009
  • Last Update Date: 10/26/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 2365599578
  • Enrollment ID: I20120703000725

Medical Identifiers

Medical identifiers for Mr Derek C Lish such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1699914044NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered TEMP RNA 19861 (Idaho)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Brigham City Community HospitalBrigham city, UTHospital
Ogden Regional Medical CenterOgden, UTHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Brigham Anesthesia, Llc93351082994
Nph Anesthesia Of Utah Llc953758431396

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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. Mr Derek C Lish allows following entities to bill medicare on his behalf.
Entity NameBrigham Anesthesia, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1710904800
PECOS PAC ID: 9335108299
Enrollment ID: O20041006000807

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Entity NameRocky Mountain Anesthesiology Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1487683215
PECOS PAC ID: 6305809492
Enrollment ID: O20041109001170

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Entity NameNph Anesthesia Of Utah Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1366077273
PECOS PAC ID: 9537584313
Enrollment ID: O20200811001268

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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. Mr Derek C Lish 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
Mr Derek C Lish, CRNA
Po Box 4268,
Portland, OR 97208-4268

Ph: (503) 372-2740
Mr Derek C Lish, CRNA
950 Medical Dr,
Brigham City, UT 84302-4724

Ph: (435) 734-9471

News Archive

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Nurse Anesthetist, Certified Registered Nurses in Brigham City, UT

Penny J Ogden, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 950 Medical Dr, Brigham City, UT 84302
Phone: 800-594-6399    Fax: 801-733-5618
Mr. Scott Christian Phillips, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 950 S 500 W, Brigham City, UT 84302
Phone: 435-734-9471    

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