Elena Khavshaba, in Montrose, CA - Medicare Nurse Practitioner

Elena Khavshaba, is a medicare enrolled "Nurse Practitioner - Family" in Montrose, California. Her current practice location is 2621 Honolulu Ave, Montrose, California. You can reach out to her office (for appointments etc.) via phone at (818) 726-7220.

Elena Khavshaba is licensed to practice in California (license number F11220384) 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 1487364808.

Contact Information

	Elena Khavshaba,
	2621 Honolulu Ave, Montrose, CA 91020-1706
	(818) 726-7220
	Not Available

Map and Direction

Provider's Profile

Full Name	Elena Khavshaba
Gender	Female
Speciality	Nurse Practitioner - Family
Location	2621 Honolulu Ave, Montrose, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1487364808
Provider Enumeration Date: 11/28/2022
Last Update Date: 04/28/2023

Medicare PECOS Information:

PECOS PAC ID: 1254780232
Enrollment ID: I20231215002730

Medical Identifiers

Medical identifiers for Elena Khavshaba such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1487364808	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	F11220384 (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. Elena Khavshaba allows following entities to bill medicare on her behalf.

Entity Name	Altea Medical California Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1174302954 PECOS PAC ID: 1850740150 Enrollment ID: O20231212002787

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. Elena Khavshaba 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
Elena Khavshaba, 1234 Richard Pl, Glendale, CA 91206-3463 Ph: (818) 726-7220	Elena Khavshaba, 2621 Honolulu Ave, Montrose, CA 91020-1706 Ph: (818) 726-7220

Reviews and Comments

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Elena Khavshaba, - Medicare Nurse Practitioner in Montrose, CA