Caitlin Provost Conlon, in Burbank, CA - Medicare Nurse Practitioner

Caitlin Provost Conlon, is a medicare enrolled "Nurse Practitioner - Family" in Burbank, California. Her current practice location is 191 S Buena Vista St, Burbank, California. You can reach out to her office (for appointments etc.) via phone at (818) 557-2671.

Caitlin Provost Conlon is licensed to practice in California (license number 95018484) 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 1003572579.

Contact Information

	Caitlin Provost Conlon,
	191 S Buena Vista St, Burbank, CA 91505-4554
	(818) 557-2671
	Not Available

Map and Direction

Provider's Profile

Full Name	Caitlin Provost Conlon
Gender	Female
Speciality	Nurse Practitioner - Family
Location	191 S Buena Vista St, Burbank, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1003572579
Provider Enumeration Date: 11/09/2021
Last Update Date: 11/09/2021

Medicare PECOS Information:

PECOS PAC ID: 0143612044
Enrollment ID: I20220127000623

Medical Identifiers

Medical identifiers for Caitlin Provost Conlon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1003572579	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	95018484 (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. Caitlin Provost Conlon allows following entities to bill medicare on her behalf.

Entity Name	Lakeside Medical Organization A Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1831426642 PECOS PAC ID: 7618005166 Enrollment ID: O20100505000015

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. Caitlin Provost Conlon 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
Caitlin Provost Conlon, 191 S Buena Vista St Ste 200, Burbank, CA 91505-4542 Ph: (818) 557-2671	Caitlin Provost Conlon, 191 S Buena Vista St, Burbank, CA 91505-4554 Ph: (818) 557-2671

Reviews and Comments

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Caitlin Provost Conlon, - Medicare Nurse Practitioner in Burbank, CA