Kelsey Vy Ngole, FNP in Fountain Valley, CA - Medicare Nurse Practitioner

Kelsey Vy Ngole, FNP is a medicare enrolled "Nurse Practitioner - Family" in Fountain Valley, California. Her current practice location is 16040 Harbor Blvd Ste G, Fountain Valley, California. You can reach out to her office (for appointments etc.) via phone at (714) 531-7930.

Kelsey Vy Ngole is licensed to practice in California (license number 95010664) 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 1083177125.

Contact Information

	Kelsey Vy Ngole, FNP
	16040 Harbor Blvd Ste G, Fountain Valley, CA 92708-1327
	(714) 531-7930
	Not Available

Map and Direction

Provider's Profile

Full Name	Kelsey Vy Ngole
Gender	Female
Speciality	Nurse Practitioner - Family
Location	16040 Harbor Blvd Ste G, Fountain Valley, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1083177125
Provider Enumeration Date: 04/06/2019
Last Update Date: 10/25/2024

Medicare PECOS Information:

PECOS PAC ID: 0941628713
Enrollment ID: I20230714002468

Medical Identifiers

Medical identifiers for Kelsey Vy Ngole such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1083177125	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	95010664 (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. Kelsey Vy Ngole allows following entities to bill medicare on her behalf.

Entity Name	Southern California Permanente Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823

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. Kelsey Vy Ngole 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
Kelsey Vy Ngole, FNP 16040 Harbor Blvd Ste G, Fountain Valley, CA 92708-1327 Ph: (714) 531-7931	Kelsey Vy Ngole, FNP 16040 Harbor Blvd Ste G, Fountain Valley, CA 92708-1327 Ph: (714) 531-7930

Reviews and Comments

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Kelsey Vy Ngole, FNP - Medicare Nurse Practitioner in Fountain Valley, CA