Iman Mattox, RN in Oakland, CA - Medicare Registered Nurse

Iman Mattox, RN is a medicare enrolled "Registered Nurse" in Oakland, California. His current practice location is 3100 Telegraph Ave, Oakland, California. You can reach out to his office (for appointments etc.) via phone at (510) 879-9200.

Iman Mattox is licensed to practice in California (license number 95199822) 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 1417613985.

Contact Information

	Iman Mattox, RN
	3100 Telegraph Ave, Oakland, CA 94609-3239
	(510) 879-9200
	Not Available

Map and Direction

Provider's Profile

Full Name	Iman Mattox
Gender	Male
Speciality	Registered Nurse
Location	3100 Telegraph Ave, Oakland, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1417613985
Provider Enumeration Date: 11/09/2021
Last Update Date: 11/09/2021

Medicare PECOS Information:

PECOS PAC ID: 4486098472
Enrollment ID: I20240217000686

Medical Identifiers

Medical identifiers for Iman Mattox such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1417613985	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	95199822 (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. Iman Mattox allows following entities to bill medicare on his behalf.

Entity Name	Wichita Anesthesiology Chartered
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1407848450 PECOS PAC ID: 4587577796 Enrollment ID: O20031112000357

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. Iman Mattox 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
Iman Mattox, RN 28078 Thorup Ln, Hayward, CA 94542-2439 Ph: (510) 885-0540	Iman Mattox, RN 3100 Telegraph Ave, Oakland, CA 94609-3239 Ph: (510) 879-9200

Reviews and Comments

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Iman Mattox, RN - Medicare Registered Nurse in Oakland, CA