Tatum Kimberly Koukladas, NP - Medicare Nurse Practitioner in Yorba Linda, CA

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Tatum Kimberly Koukladas, NP is a medicare enrolled "Nurse Practitioner - Family" in Yorba Linda, California. Her current practice location is 4300 Rose Dr, Yorba Linda, California. You can reach out to her office (for appointments etc.) via phone at (714) 577-6652.

Tatum Kimberly Koukladas is licensed to practice in California (license number 95022716) 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 1275245631.

Contact Information

Tatum Kimberly Koukladas, NP
4300 Rose Dr,
Yorba Linda, CA 92886-2026
(714) 577-6652
Not Available

Map and Direction




Provider's Profile

Full NameTatum Kimberly Koukladas
GenderFemale
SpecialityNurse Practitioner - Family
Location4300 Rose Dr, Yorba Linda, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1275245631
  • Provider Enumeration Date: 12/16/2022
  • Last Update Date: 04/19/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 8123483138
  • Enrollment ID: I20230426002279

Medical Identifiers

Medical identifiers for Tatum Kimberly Koukladas such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1275245631NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 95022716 (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. Tatum Kimberly Koukladas allows following entities to bill medicare on her behalf.
Entity NameProvidence Medical Foundation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1285890624
PECOS PAC ID: 8921993205
Enrollment ID: O20040216001346

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. Tatum Kimberly Koukladas 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 AddressPractice Location Address
Tatum Kimberly Koukladas, NP
4300 Rose Dr,
Yorba Linda, CA 92886-2026

Ph: (714) 577-6652		Tatum Kimberly Koukladas, NP
4300 Rose Dr,
Yorba Linda, CA 92886-2026

Ph: (714) 577-6652

Reviews and Comments


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Susan Wadkins, N.P.
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Medicare: Not Enrolled in Medicare
Practice Location: 4900 Prospect Ave, Yorba Linda, CA 92886
Phone: 714-528-4211    Fax: 714-528-3041

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.