Mrs Maryam Modirrousta, CNM, NP in Apple Valley, CA - Medicare Advanced Practice Midwife

Mrs Maryam Modirrousta, CNM, NP is a medicare enrolled "Advanced Practice Midwife" in Apple Valley, California. Her current practice location is 18300 Us Highway 18, Apple Valley, California. You can reach out to her office (for appointments etc.) via phone at (706) 242-2311.

Mrs Maryam Modirrousta is licensed to practice in California (license number NMW1949) 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 1548514565.

Contact Information

	Mrs Maryam Modirrousta, CNM, NP
	18300 Us Highway 18, Apple Valley, CA 92307-2206
	(706) 242-2311
	(760) 946-8875

Map and Direction

Provider's Profile

Full Name	Mrs Maryam Modirrousta
Gender	Female
Speciality	Advanced Practice Midwife
Location	18300 Us Highway 18, Apple Valley, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1548514565
Provider Enumeration Date: 10/29/2012
Last Update Date: 12/08/2021

Medicare PECOS Information:

PECOS PAC ID: 2769704790
Enrollment ID: I20141202002419

Medical Identifiers

Medical identifiers for Mrs Maryam Modirrousta such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1548514565	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367A00000X	Advanced Practice Midwife	NMW1949 (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 Maryam Modirrousta allows following entities to bill medicare on her behalf.

Entity Name	Southern California Permanente Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823

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 Maryam Modirrousta 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 Maryam Modirrousta, CNM, NP 18300 Us Highway 18, Apple Valley, CA 92307-2206 Ph: (706) 242-2311	Mrs Maryam Modirrousta, CNM, NP 18300 Us Highway 18, Apple Valley, CA 92307-2206 Ph: (706) 242-2311

Reviews and Comments

Advanced Practice Midwife Nurses in Apple Valley, CA

Ms. Kimberly Kay Tillotson, CNM/NP Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 18300 Highway 18, Apple Valley, CA 92307 Phone: 760-242-2311 Fax: 760-946-8875
Stephanie Hansen, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 18056 Wika Rd Ste B, Apple Valley, CA 92307 Phone: 760-813-3699
Mrs. Kimberly Sue Deimling-meyer, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 18300 Us Highway 18, Apple Valley, CA 92307 Phone: 760-242-2311 Fax: 760-946-8875
Laurie Roberts, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 18077 Us Highway 18, Suite 100, Apple Valley, CA 92307 Phone: 760-946-8799 Fax: 760-946-8875
Dr. Matthew Larsen, DNP, CNM, WHNP-BC Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 18077 Outer Hwy 18 Ste 100, Apple Valley, CA 92307 Phone: 760-946-8169 Fax: 760-946-8875

Mrs Maryam Modirrousta, CNM, NP - Medicare Advanced Practice Midwife in Apple Valley, CA