Prof Amjad Al-khawaldeh, PHD, CNS, NP in Laguna Hills, CA

Prof Amjad Al-khawaldeh, PHD, CNS, NP is a medicare enrolled "Nurse Practitioner" in Laguna Hills, California. His current practice location is 23961 Calle De La Magdalena Ste 200, Laguna Hills, California. You can reach out to his office (for appointments etc.) via phone at (949) 238-4100.

Prof Amjad Al-khawaldeh is licensed to practice in California (license number 95006131) 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 1477091445.

Contact Information

	Prof Amjad Al-khawaldeh, PHD, CNS, NP
	23961 Calle De La Magdalena Ste 200, Laguna Hills, CA 92653-3645
	(949) 238-4100
	Not Available

Map and Direction

Provider's Profile

Full Name	Prof Amjad Al-khawaldeh
Gender	Male
Speciality	Nurse Practitioner
Location	23961 Calle De La Magdalena Ste 200, Laguna Hills, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1477091445
Provider Enumeration Date: 02/09/2017
Last Update Date: 01/14/2025

Medicare PECOS Information:

PECOS PAC ID: 9133537269
Enrollment ID: I20210409000761

Medical Identifiers

Medical identifiers for Prof Amjad Al-khawaldeh such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1477091445	NPI	-	NPPES
95006131	Other	CA	NP LICENSE AND FURNISHING NUMBER

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	95006131 (California)	Primary
163W00000X	Registered Nurse	539548 (California)	Secondary

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. Prof Amjad Al-khawaldeh allows following entities to bill medicare on his behalf.

Entity Name	Regents Of The University Of California
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1811255060 PECOS PAC ID: 8527223304 Enrollment ID: O20120628000360

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. Prof Amjad Al-khawaldeh 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
Prof Amjad Al-khawaldeh, PHD, CNS, NP 2012 Fallen Leaf Pl, Tustin, CA 92780-6713 Ph: (714) 875-3755	Prof Amjad Al-khawaldeh, PHD, CNS, NP 23961 Calle De La Magdalena Ste 200, Laguna Hills, CA 92653-3645 Ph: (949) 238-4100

Reviews and Comments

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Prof Amjad Al-khawaldeh, PHD, CNS, NP - Medicare Nurse Practitioner in Laguna Hills, CA