Shaun Mardani, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in San Clemente, California. His current practice location is
120 Calle Amistad Unit 3207, San Clemente, California. You can reach out to his office (for appointments etc.) via phone at
(949) 292-3023.
Shaun Mardani is licensed to practice in California (license number 4443) 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 1366870008.
Provider's Profile
| Full Name | Shaun Mardani |
|---|
| Gender | Male |
|---|
| Speciality | Nurse Anesthetist, Certified Registered |
|---|
| Location | 120 Calle Amistad Unit 3207, San Clemente, California |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1366870008
- Provider Enumeration Date: 10/16/2013
- Last Update Date: 12/27/2021
Medicare PECOS Information:
- PECOS PAC ID: 9830313121
- Enrollment ID: I20140605002240
Medical Identifiers
Medical identifiers for Shaun Mardani such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1366870008 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163W00000X | Registered Nurse | 767550 (California) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 4443 (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. Shaun Mardani allows following entities to bill medicare on his behalf.
| Entity Name | Southern California Permanente Medical Group |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1770515280
PECOS PAC ID: 6002729175
Enrollment ID: O20031110000678 |
|---|
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. Shaun Mardani 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 |
|---|
Shaun Mardani, CRNA
120 Calle Amistad Unit 3207,
San Clemente, CA 92673-6923
Ph: (949) 292-3023 | Shaun Mardani, CRNA
120 Calle Amistad Unit 3207,
San Clemente, CA 92673-6923
Ph: (949) 292-3023 |
Reviews and Comments