Dr Golareh Fazilat, MD is a medicare enrolled "Ophthalmology" physician in Lake Forest, California. Her current practice location is
23832 Rockfield Blvd Ste 150, Lake Forest, California. You can reach out to her office (for appointments etc.) via phone at
(949) 502-3333.
Dr Golareh Fazilat is licensed to practice in California (license number A10143) 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 1881880896.
Physician's Profile
| Full Name | Dr Golareh Fazilat |
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| Gender | Female |
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| Speciality | Ophthalmology |
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| Location | 23832 Rockfield Blvd Ste 150, Lake Forest, 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: 1881880896
- Provider Enumeration Date: 09/24/2007
- Last Update Date: 04/29/2020
Medicare PECOS Information:
- PECOS PAC ID: 3870719297
- Enrollment ID: I20140721002041
Medical Identifiers
Medical identifiers for Dr Golareh Fazilat such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1881880896 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207WX0110X | Ophthalmology - Pediatric Ophthalmology And Strabismus Specialist | A10143 (California) | Secondary |
| 207W00000X | Ophthalmology | A10143 (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. Dr Golareh Fazilat allows following entities to bill medicare on her behalf.
| Entity Name | G Fazilat Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1275841223
PECOS PAC ID: 8628346632
Enrollment ID: O20170615002433 |
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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. Dr Golareh Fazilat 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 |
|---|
Dr Golareh Fazilat, MD
23832 Rockfield Blvd Ste 150,
Lake Forest, CA 92630-2820
Ph: (949) 502-3333 | Dr Golareh Fazilat, MD
23832 Rockfield Blvd Ste 150,
Lake Forest, CA 92630-2820
Ph: (949) 502-3333 |
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