Marlon Roa Reyes, MSN PMHNP-BC - Medicare Nurse Practitioner in Gardena, CA

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Marlon Roa Reyes, MSN PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Gardena, California. His current practice location is 1225 W 190th St Ste 280, Gardena, California. You can reach out to his office (for appointments etc.) via phone at (310) 515-8113.

Marlon Roa Reyes is licensed to practice in California (license number 95020637) 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 1134861123.

Contact Information

Marlon Roa Reyes, MSN PMHNP-BC
1225 W 190th St Ste 280,
Gardena, CA 90248-4305
(310) 515-8113
(310) 538-2102

Map and Direction




Provider's Profile

Full NameMarlon Roa Reyes
GenderMale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location1225 W 190th St Ste 280, Gardena, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1134861123
  • Provider Enumeration Date: 04/11/2022
  • Last Update Date: 06/02/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 2264809862
  • Enrollment ID: I20221111000919

Medical Identifiers

Medical identifiers for Marlon Roa Reyes such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1134861123NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health 11019279 (Florida)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 852172 (Nevada)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 95020637 (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. Marlon Roa Reyes allows following entities to bill medicare on his behalf.
Entity NameEhab Yacoub Md Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1417373713
PECOS PAC ID: 5092099523
Enrollment ID: O20170301002071

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. Marlon Roa Reyes 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 AddressPractice Location Address
Marlon Roa Reyes, MSN PMHNP-BC
304 S Jones Blvd # 1109,
Las Vegas, NV 89107-2623

Ph: (702) 840-8518		Marlon Roa Reyes, MSN PMHNP-BC
1225 W 190th St Ste 280,
Gardena, CA 90248-4305

Ph: (310) 515-8113

Reviews and Comments


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Ms. Adaljiza Tavera, PMHNP, FNP
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Medicare: Accepting Medicare Assignments
Practice Location: 1225 W 190th St Ste 280, Gardena, CA 90248
Phone: 310-515-8113    Fax: 310-538-2102
Anna Smith,
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Phone: 310-529-4211    
Amechi Lilian Obodoagha,
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Phone: 424-263-0728    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.