Mr Mark Alan Logan, PMHNP-BC in Los Angeles, CA

Mr Mark Alan Logan, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Los Angeles, California. His current practice location is 538 N Detroit St, Los Angeles, California. You can reach out to his office (for appointments etc.) via phone at (310) 751-1080.

Mr Mark Alan Logan is licensed to practice in California (license number 95013193) 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 1780107433.

Contact Information

	Mr Mark Alan Logan, PMHNP-BC
	538 N Detroit St, Los Angeles, CA 90036-1949
	(310) 751-1080
	(844) 941-1989

Map and Direction

Provider's Profile

Full Name	Mr Mark Alan Logan
Gender	Male
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	538 N Detroit St, Los Angeles, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1780107433
Provider Enumeration Date: 07/24/2017
Last Update Date: 03/26/2024

Medicare PECOS Information:

PECOS PAC ID: 2062840879
Enrollment ID: I20200310000495

Medical Identifiers

Medical identifiers for Mr Mark Alan Logan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1780107433	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	95013193 (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. Mr Mark Alan Logan allows following entities to bill medicare on his behalf.

Entity Name	Grow Healthcare Group Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1154994846 PECOS PAC ID: 1850774746 Enrollment ID: O20220809004080

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 Mark Alan Logan 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 Mark Alan Logan, PMHNP-BC 538 N Detroit St, Los Angeles, CA 90036-1949 Ph: (310) 751-1080	Mr Mark Alan Logan, PMHNP-BC 538 N Detroit St, Los Angeles, CA 90036-1949 Ph: (310) 751-1080

Reviews and Comments

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Mr Mark Alan Logan, PMHNP-BC - Medicare Nurse Practitioner in Los Angeles, CA