Lacey Michelle Harvey, PA-C
Individual provider Active NPI Physician Assistant · Huntertown, IN
NPI 1295207488 · NPPES record last updated Aug 5, 2024
Key facts
- NPI
- 1295207488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 10002642A (IN)
- Practice address
- PO Box 670
Huntertown, IN 46748-0670 - Phone
- (260) 748-3650
- Fax
- (260) 748-3651
- NPI assigned
- Dec 28, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Summit Radiology P C
Practice addresses (Care Compare)
5001 US Hwy 30 W D
Fort Wayne, IN 46818-9701
Phone (260) 432-1568
7601 W Jefferson
Fort Wayne Orthopaedics
Fort Wayne, IN 46804-4133
Phone (260) 436-8686
7631 W Jefferson Blvd
Fort Wayne, IN 46804-4133
Phone (260) 436-7770
7900 W Jefferson Blvd
104 Interventional Clinic
Fort Wayne, IN 46804-4128
Phone (260) 435-7951
7950 W Jefferson Blvd
Lutheran Hospital of Fort Wayne
Fort Wayne, IN 46804-4140
Phone (260) 435-7001
7952 W Jefferson Blvd
Orthopaedic Hospital of Lutheran Network
Fort Wayne, IN 46804-4140
Phone (260) 435-7001
7956 W Jefferson Blvd
120 Allied Imaging II
Fort Wayne, IN 46804-4140
Phone (260) 436-2416
7970 W Jefferson Blvd
Rehabilitation Hospital of Fort Way
Fort Wayne, IN 46804-4140
Phone (260) 435-6142
7988 W Jefferson Blvd
Summit Radiology/Womens Health Adva
Fort Wayne, IN 46804-4140
Phone (260) 432-1568
Hospital & facility affiliations
- Lutheran Hospital of Indiana
- Marion General Hospital
- Kosciusko Community Hospital
- The Orthopaedic Hospital of Lutheran Health Networ
- Bluffton Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.96 of 100
- Quality
- 92.18
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190109002150 | IN | Practitioner - Physician Assistant | 8628314853 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10002642A | IN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopaedics Northeast PC | Current |
Accepting new patients | |
| Racc Medical Associates LLC | Current |
Accepting new patients | |
| Racc Medical Associates LLC | Current |
Accepting new patients | |
| Orthopaedics Northeast PC | Current |
Accepting new patients |
Locations
1314 E 7th St
Ste 201
Auburn, IN 46706
Phone (260) 927-0400
5050 N Clinton St
Fort Wayne, IN 46825
Phone (219) 484-8551
5052 N Clinton St
Fort Wayne, IN 46825
Phone (260) 408-2203
1721 Magnavox Way
Fort Wayne, IN 46804
Phone (260) 250-0001
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10002642A | IN | Yes |
Addresses
Primary practice location
PO Box 670
Huntertown, IN 46748-0670
Mailing address
PO Box 670
Huntertown, IN 46748-0670
Phone (260) 748-3650
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300021709 | Medicaid | IN |
Other names
- Lacey Michelle Lopez
Other providers in Huntertown, IN
- Claire Marie Ellingson
- Essential Helpers Homecare Services LLC
- Lela Dawn Fortune-Brown
- Felipe Guerra
- Lauren Hale
- Huntertown Dental Group, P.C.
- Huntertown Dental Services, Inc.
- Infusion Care Group LLC
- Jill Johnson
- Kash Medical Holdings LLC
All providers in Huntertown, IN · Physician Assistant in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.