Jose Carlos Chavez, NP is a medicare enrolled "Clinical Nurse Specialist - Women's Health" in San Bernardino, California. His current practice location is
850 W Highland Ave, Suite A, San Bernardino, California. You can reach out to his office (for appointments etc.) via phone at
(909) 886-7576.
Jose Carlos Chavez is licensed to practice in California (license number 14641) 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 1629234893.
Provider's Profile
| Full Name | Jose Carlos Chavez |
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| Gender | Male |
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| Speciality | Clinical Nurse Specialist - Women's Health |
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| Location | 850 W Highland Ave, San Bernardino, 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: 1629234893
- Provider Enumeration Date: 08/06/2008
- Last Update Date: 03/12/2014
Medicare PECOS Information:
- PECOS PAC ID: 2961548037
- Enrollment ID: I20091002000137
Medical Identifiers
Medical identifiers for Jose Carlos Chavez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1629234893 | NPI | - | NPPES |
| 1629234893 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 364SW0102X | Clinical Nurse Specialist - Women's Health | 14641 (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. Jose Carlos Chavez allows following entities to bill medicare on his behalf.
| Entity Name | County Of San Bernardino |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1164467023
PECOS PAC ID: 3870499130
Enrollment ID: O20031209000420 |
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| Entity Name | Viruch Vachirakorntong Md Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1992754899
PECOS PAC ID: 0941210751
Enrollment ID: O20060424000653 |
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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. Jose Carlos Chavez 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 |
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Jose Carlos Chavez, NP
17299 Cremello Way,
Moreno Valley, CA 92555-3369
Ph: () - | Jose Carlos Chavez, NP
850 W Highland Ave, Suite A,
San Bernardino, CA 92405-3855
Ph: (909) 886-7576 |
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