Dr Charleson Prince Godio Agustin, DPT, CMT, CSCS is a medicare enrolled "Physical Therapist" provider in Westminster, California. His current practice location is
6000 Garden Grove Blvd, Westminster, California. You can reach out to his office (for appointments etc.) via phone at
(562) 270-1605.
Dr Charleson Prince Godio Agustin is licensed to practice in * (Not Available) (license number ) 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 1447999388.
Healthcare Provider's Profile
| Full Name | Dr Charleson Prince Godio Agustin |
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| Gender | Male |
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| Speciality | Physical Therapist |
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| Location | 6000 Garden Grove Blvd, Westminster, 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: 1447999388
- Provider Enumeration Date: 05/31/2022
- Last Update Date: 09/07/2022
Medicare PECOS Information:
- PECOS PAC ID: 1153797352
- Enrollment ID: I20221012003543
Medical Identifiers
Medical identifiers for Dr Charleson Prince Godio Agustin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1447999388 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225700000X | Massage Therapist | 79389 (California) | Secondary |
| 225100000X | Physical Therapist | (* (Not Available)) | 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 Charleson Prince Godio Agustin allows following entities to bill medicare on his behalf.
| Provider Name | California Rehabilitation & Sports Therapy A California Physical Ther |
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| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Provider Identifiers | NPI Number: 1386696409
PECOS PAC ID: 6709788896
Enrollment ID: O20040120001115 |
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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 Charleson Prince Godio Agustin 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 Charleson Prince Godio Agustin, DPT, CMT, CSCS
6000 Garden Grove Blvd Apt 238,
Westminster, CA 92683-1955
Ph: (626) 756-5036 | Dr Charleson Prince Godio Agustin, DPT, CMT, CSCS
6000 Garden Grove Blvd,
Westminster, CA 92683-1976
Ph: (562) 270-1605 |
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