Pavel Ksendz, PMHNP in Santa Clarita, CA - Medicare Nurse Practitioner

Pavel Ksendz, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Santa Clarita, California. His current practice location is 21700 Golden Triangle Rd Ste 104a, Santa Clarita, California. You can reach out to his office (for appointments etc.) via phone at (310) 849-4541.

Pavel Ksendz is licensed to practice in California (license number 95021622) 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 1790406882.

Contact Information

	Pavel Ksendz, PMHNP
	21700 Golden Triangle Rd Ste 104a, Santa Clarita, CA 91350-2616
	(310) 849-4541
	Not Available

Map and Direction

Provider's Profile

Full Name	Pavel Ksendz
Gender	Male
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	21700 Golden Triangle Rd Ste 104a, Santa Clarita, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1790406882
Provider Enumeration Date: 09/07/2022
Last Update Date: 09/07/2022

Medicare PECOS Information:

PECOS PAC ID: 6901268739
Enrollment ID: I20230810003847

Medical Identifiers

Medical identifiers for Pavel Ksendz such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1790406882	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	95021622 (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. Pavel Ksendz allows following entities to bill medicare on his behalf.

Entity Name	Oc Progressive Recovery Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003340217 PECOS PAC ID: 7214207190 Enrollment ID: O20170726000348

Entity Name	Amygdala Medical Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1386324267 PECOS PAC ID: 3577910421 Enrollment ID: O20231114002865

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. Pavel Ksendz 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
Pavel Ksendz, PMHNP 21700 Golden Triangle Rd Ste 104a, Santa Clarita, CA 91350-2616 Ph: (310) 849-4541	Pavel Ksendz, PMHNP 21700 Golden Triangle Rd Ste 104a, Santa Clarita, CA 91350-2616 Ph: (310) 849-4541

Reviews and Comments

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Pavel Ksendz, PMHNP - Medicare Nurse Practitioner in Santa Clarita, CA