Mr Aldrich Jereny Gamboa, FNP in Long Beach, CA

Mr Aldrich Jereny Gamboa, FNP is a medicare enrolled "Nurse Practitioner - Family" in Long Beach, California. His current practice location is 200 Oceangate Ste 100, Long Beach, California. You can reach out to his office (for appointments etc.) via phone at (888) 562-5442.

Mr Aldrich Jereny Gamboa is licensed to practice in New York (license number 352113) 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 1639530959.

Contact Information

	Mr Aldrich Jereny Gamboa, FNP
	200 Oceangate Ste 100, Long Beach, CA 90802-4317
	(888) 562-5442
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Aldrich Jereny Gamboa
Gender	Male
Speciality	Nurse Practitioner - Family
Location	200 Oceangate Ste 100, Long Beach, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1639530959
Provider Enumeration Date: 03/14/2016
Last Update Date: 06/07/2023

Medicare PECOS Information:

PECOS PAC ID: 6406214774
Enrollment ID: I20230619000167

Medical Identifiers

Medical identifiers for Mr Aldrich Jereny Gamboa such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1639530959	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	712220-1 (New York)	Secondary
363LF0000X	Nurse Practitioner - Family	352113 (New York)	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. Mr Aldrich Jereny Gamboa allows following entities to bill medicare on his behalf.

Entity Name	Molina Healthcare Of New York Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1134622970 PECOS PAC ID: 8628468337 Enrollment ID: O20211210001127

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. Mr Aldrich Jereny Gamboa 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
Mr Aldrich Jereny Gamboa, FNP 175 Academy Ave, Staten Island, NY 10309-3215 Ph: (347) 671-5158	Mr Aldrich Jereny Gamboa, FNP 200 Oceangate Ste 100, Long Beach, CA 90802-4317 Ph: (888) 562-5442

Reviews and Comments

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Mr Aldrich Jereny Gamboa, FNP - Medicare Nurse Practitioner in Long Beach, CA