Edmond L Otis, in Moreno Valley, CA - Medicare Marriage & Family Therapist Provider

Edmond L Otis, is a medicare enrolled "Marriage & Family Therapist" provider in Moreno Valley, California. His current practice location is 26449 Bodega Ct, Moreno Valley, California. You can reach out to his office (for appointments etc.) via phone at (760) 612-7029.

Edmond L Otis is licensed to practice in California (license number 31194) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1619681251.

Contact Information

	Edmond L Otis,
	26449 Bodega Ct, Moreno Valley, CA 92555-2461
	(760) 612-7029
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Edmond L Otis
Gender	Male
Speciality	Marriage & Family Therapist
Location	26449 Bodega Ct, Moreno Valley, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1619681251
Provider Enumeration Date: 01/09/2023
Last Update Date: 01/09/2023

Medicare PECOS Information:

PECOS PAC ID: 5496190688
Enrollment ID: I20240227004053

Medical Identifiers

Medical identifiers for Edmond L Otis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1619681251	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
106H00000X	Marriage & Family Therapist	31194 (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. Edmond L Otis allows following entities to bill medicare on his behalf.

Entity Name	Grow Healthcare Group Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20210414000053

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. Edmond L Otis 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
Edmond L Otis, 1242 University Ave Ste 6-570, Riverside, CA 92507-8810 Ph: (760) 612-7029	Edmond L Otis, 26449 Bodega Ct, Moreno Valley, CA 92555-2461 Ph: (760) 612-7029

Reviews and Comments

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Edmond L Otis, - Medicare Couples Therapy in Moreno Valley, CA