Kenneth E Grullon, MD in Antioch, CA - Medicare Obstetrics & Gynecology

Kenneth E Grullon, MD is a medicare enrolled "Obstetrics & Gynecology" physician in Antioch, California. His current practice location is 3400 Delta Fair Blvd, Antioch, California. You can reach out to his office (for appointments etc.) via phone at (925) 779-5000.

Kenneth E Grullon is licensed to practice in California (license number G76376) 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 1801974977.

Contact Information

	Kenneth E Grullon, MD
	3400 Delta Fair Blvd, Antioch, CA 94509-4004
	(925) 779-5000
	Not Available

Map and Direction

Physician's Profile

Full Name	Kenneth E Grullon
Gender	Male
Speciality	Obstetrics & Gynecology
Location	3400 Delta Fair Blvd, Antioch, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1801974977
Provider Enumeration Date: 11/02/2006
Last Update Date: 12/17/2021

Medicare PECOS Information:

PECOS PAC ID: 5799821377
Enrollment ID: I20101209001277

Medical Identifiers

Medical identifiers for Kenneth E Grullon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1801974977	NPI	-	NPPES
00G763760	Medicaid	CA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207V00000X	Obstetrics & Gynecology	G76376 (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. Kenneth E Grullon allows following entities to bill medicare on his behalf.

Entity Name	Permanente Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710

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. Kenneth E Grullon 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
Kenneth E Grullon, MD 1800 Harrison St Fl 7, Oakland, CA 94612-3466 Ph: (510) 625-6262	Kenneth E Grullon, MD 3400 Delta Fair Blvd, Antioch, CA 94509-4004 Ph: (925) 779-5000

Reviews and Comments

Obstetrics & Gynecology Doctors in Antioch, CA

Jessica Lennon, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 4053 Lone Tree Way Ste 100, Antioch, CA 94531 Phone: 925-756-3400
Dr. Daniel L Zimmerman, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 3737 Lone Tree Way, Antioch, CA 94509 Phone: 925-754-9223 Fax: 925-754-3945
Anahita Latorra, Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 4501 Sand Creek Rd, Antioch, CA 94531 Phone: 925-813-3400
Kyla Ai-lan Yee, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 4053 Lone Tree Way, #101, Antioch, CA 94531 Phone: 925-756-3400 Fax: 925-757-0849
Mary C. Klemm, DO Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 5601 Deer Valley Rd, Antioch, CA 94531 Phone: 925-813-6500
Kelly Park, D.O. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 4501 Sand Creek Rd, Antioch, CA 94531 Phone: 925-813-6500
Nicole Kathryn Shelton, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 4501 Sand Creek Rd, Antioch, CA 94531 Phone: 925-813-3400

Kenneth E Grullon, MD - Medicare Obstetrics & Gynecology in Antioch, CA