Soheil Daniel Gideon, is a medicare enrolled "Hospitalist" physician in Valley Village, California. His current practice location is
12629 Riverside Dr Apt 337, Valley Village, California. You can reach out to his office (for appointments etc.) via phone at
(818) 625-9439.
Soheil Daniel Gideon is licensed to practice in California (license number A184590) 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 1144780719.
Physician's Profile
| Full Name | Soheil Daniel Gideon |
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| Gender | Male |
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| Speciality | Hospitalist |
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| Location | 12629 Riverside Dr Apt 337, Valley Village, 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: 1144780719
- Provider Enumeration Date: 03/20/2019
- Last Update Date: 11/08/2024
Medicare PECOS Information:
- PECOS PAC ID: 1355708538
- Enrollment ID: I20230602000307
Medical Identifiers
Medical identifiers for Soheil Daniel Gideon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1144780719 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207R00000X | Internal Medicine | A184590 (California) | Secondary |
| 208M00000X | Hospitalist | A184590 (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. Soheil Daniel Gideon allows following entities to bill medicare on his behalf.
| Entity Name | Fountain Valley Group Services Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1013310309
PECOS PAC ID: 9931427382
Enrollment ID: O20150417000931 |
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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. Soheil Daniel Gideon 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 |
|---|
Soheil Daniel Gideon,
12629 Riverside Dr Apt 337,
Valley Village, CA 91607-3490
Ph: (818) 625-9439 | Soheil Daniel Gideon,
12629 Riverside Dr Apt 337,
Valley Village, CA 91607-3490
Ph: (818) 625-9439 |
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