Christian Custodio, FNP in Pomona, CA - Medicare Nurse Practitioner

Christian Custodio, FNP is a medicare enrolled "Nurse Practitioner - Primary Care" in Pomona, California. He graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Mallu Reddy Md Inc and his current practice location is 1196 N Park Ave, Pomona, California. You can reach out to his office (for appointments etc.) via phone at (909) 623-4050.

Christian Custodio is licensed to practice in California (license number 95015354) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1811502404.

Contact Information

	Christian Custodio, FNP
	1196 N Park Ave, Pomona, CA 91768-3027
	(909) 623-4050
	Not Available

Map and Direction

Provider's Profile

Full Name	Christian Custodio
Gender	Male
Speciality	Nurse Practitioner
Experience	4 Years
Location	1196 N Park Ave, Pomona, California
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Christian Custodio graduated from nursing school in 2020

NPI Data:

NPI Number: 1811502404
Provider Enumeration Date: 09/10/2020
Last Update Date: 09/10/2020

Medicare PECOS Information:

PECOS PAC ID: 0648683789
Enrollment ID: I20210108000940

Medical Identifiers

Medical identifiers for Christian Custodio such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1811502404	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP2300X	Nurse Practitioner - Primary Care	95015354 (California)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Mallu Reddy Md Inc	8022193994	3

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. Christian Custodio allows following entities to bill medicare on his behalf.

Entity Name	Mallu Reddy Md Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1184821340 PECOS PAC ID: 8022193994 Enrollment ID: O20080317000645

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. Christian Custodio 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
Christian Custodio, FNP 1196 N Park Ave, Pomona, CA 91768-3027 Ph: (909) 623-4050	Christian Custodio, FNP 1196 N Park Ave, Pomona, CA 91768-3027 Ph: (909) 623-4050

Reviews and Comments

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Christian Custodio, FNP - Medicare Nurse Practitioner in Pomona, CA