Mrs Doris Therese Crisostomo Untalan, CNM in San Leandro, CA

Mrs Doris Therese Crisostomo Untalan, CNM is a medicare enrolled "Advanced Practice Midwife" in San Leandro, California. Her current practice location is 2500 Merced Street, San Leandro, California. You can reach out to her office (for appointments etc.) via phone at (510) 454-1000.

Mrs Doris Therese Crisostomo Untalan is licensed to practice in California (license number NMW 1079) 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 1457427940.

Contact Information

	Mrs Doris Therese Crisostomo Untalan, CNM
	2500 Merced Street, San Leandro, CA 94577-4201
	(510) 454-1000
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Doris Therese Crisostomo Untalan
Gender	Female
Speciality	Advanced Practice Midwife
Location	2500 Merced Street, San Leandro, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1457427940
Provider Enumeration Date: 11/27/2006
Last Update Date: 02/11/2022

Medicare PECOS Information:

PECOS PAC ID: 7810111614
Enrollment ID: I20140618000894

Medical Identifiers

Medical identifiers for Mrs Doris Therese Crisostomo Untalan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1457427940	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367A00000X	Advanced Practice Midwife	NMW 1079 (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. Mrs Doris Therese Crisostomo Untalan allows following entities to bill medicare on her behalf.

Entity Name	Permanente Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710

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. Mrs Doris Therese Crisostomo Untalan 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
Mrs Doris Therese Crisostomo Untalan, CNM 2500 Merced Street, San Leandro, CA 94577-4201 Ph: (510) 454-1000	Mrs Doris Therese Crisostomo Untalan, CNM 2500 Merced Street, San Leandro, CA 94577-4201 Ph: (510) 454-1000

Reviews and Comments

Advanced Practice Midwife Nurses in San Leandro, CA

Mrs. Mary Ann Quarto Bloyer, C.N.M. Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 2500 Merced Street, San Leandro, CA 94577 Phone: 510-454-1000
Ms. Jessica Rae Martinez, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 2500 Merced St, San Leandro, CA 94577 Phone: 925-548-4751
Ms. Rebecca Mitchell, Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 2275 Arlington Dr, San Leandro, CA 94578 Phone: 510-317-1444
Madeleine Belizaire, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 2500 Merced St, San Leandro, CA 94577 Phone: 510-454-1000
Ms. Sarah Futernick, C.N.M, D.N.P Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 2500 Merced St, Ob/gyn Department - 3rd Floor, San Leandro, CA 94577 Phone: 415-572-6915
Ms. Sylvia Ann Berman, C.N.M. Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 2500 Merced St, San Leandro, CA 94577 Phone: 510-454-1000

Mrs Doris Therese Crisostomo Untalan, CNM - Medicare Advanced Practice Midwife in San Leandro, CA