Jennifer Tello, is a medicare enrolled "Social Worker - Clinical" provider in Los Angeles, California. Her current practice location is
12001 W Washington Blvd, Los Angeles, California. You can reach out to her office (for appointments etc.) via phone at
(833) 574-2273.
Jennifer Tello is licensed to practice in California (license number 101587) 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 1447651278.
Healthcare Provider's Profile
| Full Name | Jennifer Tello |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 12001 W Washington Blvd, Los Angeles, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1447651278
- Provider Enumeration Date: 09/11/2014
- Last Update Date: 02/25/2022
Medicare PECOS Information:
- PECOS PAC ID: 1658768684
- Enrollment ID: I20220421002059
Medical Identifiers
Medical identifiers for Jennifer Tello such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1447651278 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | 80314 (California) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Secondary |
| 225400000X | Rehabilitation Practitioner | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 101587 (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. Jennifer Tello allows following entities to bill medicare on her behalf.
| Entity Name | Southern California Permanente Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1770515280
PECOS PAC ID: 6002729175
Enrollment ID: O20031110000678 |
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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. Jennifer Tello 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 |
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Jennifer Tello,
155 N Occidental Blvd,
Los Angeles, CA 90026-4641
Ph: (213) 381-2931 | Jennifer Tello,
12001 W Washington Blvd,
Los Angeles, CA 90066-5801
Ph: (833) 574-2273 |
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