Ski Run Optometry By Dr Maldonado And Dr. London is a medicare enrolled "Optometrist" provider in S Lake Tahoe, California. Their current practice location is
3637 Larch Ave Ste 2, S Lake Tahoe, California. You can reach out to their office (for appointments etc.) via phone at
(530) 544-3403.
Ski Run Optometry By Dr Maldonado And Dr. London is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Ski Run Optometry By Dr Maldonado And Dr. London
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1558957589.
Healthcare Provider's Profile
| Full Name | Ski Run Optometry By Dr Maldonado And Dr. London |
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| Type | Facility |
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| Speciality | Optometrist |
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| Location | 3637 Larch Ave Ste 2, S Lake Tahoe, California |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1558957589
- Provider Enumeration Date: 12/14/2020
- Last Update Date: 12/14/2020
Medicare PECOS Information:
- PECOS PAC ID: 3072927771
- Enrollment ID: O20210120001611
Medical Identifiers
Medical identifiers for Ski Run Optometry By Dr Maldonado And Dr. London such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1558957589 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Ski Run Optometry By Dr Maldonado And Dr. London acts as a billing entity for following providers:
| Provider Name | Andrea Maldonado |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1467014118
PECOS PAC ID: 1759705452
Enrollment ID: I20210201002241 |
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| Provider Name | Kellie London |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1134710932
PECOS PAC ID: 5092123265
Enrollment ID: I20210428001476 |
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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. Ski Run Optometry By Dr Maldonado And Dr. London 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 |
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Ski Run Optometry By Dr Maldonado And Dr. London
3637 Larch Ave Ste 2,
S Lake Tahoe, CA 96150-8478
Ph: (530) 544-3403 | Ski Run Optometry By Dr Maldonado And Dr. London
3637 Larch Ave Ste 2,
S Lake Tahoe, CA 96150-8478
Ph: (530) 544-3403 |
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