Lucila Mora, CNM,NP is a medicare enrolled "Advanced Practice Midwife" in Fairfield, California. Her current practice location is
1860 Pennsylvania Ave, Suite 300a, Fairfield, California. You can reach out to her office (for appointments etc.) via phone at
(707) 438-7600.
Lucila Mora is licensed to practice in California (license number 1346) 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 1407927957.
Provider's Profile
| Full Name | Lucila Mora |
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| Gender | Female |
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| Speciality | Advanced Practice Midwife |
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| Location | 1860 Pennsylvania Ave, Fairfield, 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: 1407927957
- Provider Enumeration Date: 11/13/2006
- Last Update Date: 02/11/2022
Medicare PECOS Information:
- PECOS PAC ID: 0749358992
- Enrollment ID: I20180214002457
Medical Identifiers
Medical identifiers for Lucila Mora such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1407927957 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LX0001X | Nurse Practitioner - Obstetrics & Gynecology | 488965 (California) | Primary |
| 367A00000X | Advanced Practice Midwife | 1346 (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. Lucila Mora allows following entities to bill medicare on her behalf.
| Entity Name | Permanente Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073606299
PECOS PAC ID: 8921910225
Enrollment ID: O20031104000710 |
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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. Lucila Mora 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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Lucila Mora, CNM,NP
4315 Melody Ln,
Vallejo, CA 94591-6355
Ph: (707) 648-1137 | Lucila Mora, CNM,NP
1860 Pennsylvania Ave, Suite 300a,
Fairfield, CA 94533-3590
Ph: (707) 438-7600 |
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