Audrey Jean Dasilva, is a medicare enrolled "Pediatrics" physician in South Lake Tahoe, California. Her current practice location is
2201 South Ave, South Lake Tahoe, California. You can reach out to her office (for appointments etc.) via phone at
(530) 543-5550.
Audrey Jean Dasilva is licensed to practice in California (license number A182796) 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 1548897119.
Physician's Profile
Full Name | Audrey Jean Dasilva |
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Gender | Female |
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Speciality | Pediatrics |
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Location | 2201 South Ave, South Lake Tahoe, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1548897119
- Provider Enumeration Date: 03/24/2020
- Last Update Date: 06/13/2023
Medicare PECOS Information:
- PECOS PAC ID: 3779981618
- Enrollment ID: I20230901003044
Medical Identifiers
Medical identifiers for Audrey Jean Dasilva such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1548897119 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | PTL3653 (California) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
208000000X | Pediatrics | A182796 (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. Audrey Jean Dasilva allows following entities to bill medicare on her behalf.
Entity Name | Barton Medical Foundation |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1750950499 PECOS PAC ID: 5395127682 Enrollment ID: O20220803001208 |
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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. Audrey Jean Dasilva 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 |
Audrey Jean Dasilva, 2201 South Ave, South Lake Tahoe, CA 96150-7025 Ph: () - | Audrey Jean Dasilva, 2201 South Ave, South Lake Tahoe, CA 96150-7025 Ph: (530) 543-5550 |
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