Dr Randall Lee Ahn, PHD, MLIS in Fontana, CA - Medicare Psychologist Provider

Dr Randall Lee Ahn, PHD, MLIS is a medicare enrolled "Psychologist - Clinical Child & Adolescent" provider in Fontana, California. His current practice location is 16465 Sierra Lakes Pkwy Ste 140, Fontana, California. You can reach out to his office (for appointments etc.) via phone at (909) 244-9593.

Dr Randall Lee Ahn is licensed to practice in California (license number PSY13956) 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 1093939399.

Contact Information

	Dr Randall Lee Ahn, PHD, MLIS
	16465 Sierra Lakes Pkwy Ste 140, Fontana, CA 92336-1242
	(909) 244-9593
	(833) 903-0337

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Randall Lee Ahn
Gender	Male
Speciality	Psychologist - Clinical Child & Adolescent
Location	16465 Sierra Lakes Pkwy Ste 140, Fontana, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1093939399
Provider Enumeration Date: 04/11/2007
Last Update Date: 05/07/2024

Medicare PECOS Information:

PECOS PAC ID: 7810336591
Enrollment ID: I20240415000284

Medical Identifiers

Medical identifiers for Dr Randall Lee Ahn such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1093939399	NPI	-	NPPES
PSY13956	Other	CA	PSYCHOLOGY LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC2200X	Psychologist - Clinical Child & Adolescent	PSY13956 (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. Dr Randall Lee Ahn allows following entities to bill medicare on his behalf.

Entity Name	Anthony Benigno Psyd Psychological Services Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1295202943 PECOS PAC ID: 5193068765 Enrollment ID: O20190522001938

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. Dr Randall Lee Ahn 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
Dr Randall Lee Ahn, PHD, MLIS 241 E 17th St # 1029, Costa Mesa, CA 92627-3831 Ph: (949) 414-7149	Dr Randall Lee Ahn, PHD, MLIS 16465 Sierra Lakes Pkwy Ste 140, Fontana, CA 92336-1242 Ph: (909) 244-9593

Reviews and Comments

Psychologist in Fontana, CA

Dr. Alexandra Mendez, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 16465 Sierra Lakes Pkwy Ste 140, Fontana, CA 92336 Phone: 909-244-9593
Vicki J Mcwain, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 17216 Slover Ave, Building L, Fontana, CA 92337 Phone: 909-854-3420
Adamma Unaka, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 6572 Almeria St, Fontana, CA 92336 Phone: 909-231-4134
Dr. Janna Maria Casillas, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 16465 Sierra Lakes Pkwy Ste 140, Fontana, CA 92336 Phone: 909-244-9593 Fax: 833-903-0337
Dr. Anthony Benigno, PSY.D. Psychologist Medicare: Medicare Enrolled Practice Location: 16465 Sierra Lakes Pkwy Ste 140, Fontana, CA 92336 Phone: 909-244-9593
Lisamarie Shelton, PSYCHOLOGIST Psychologist Medicare: Medicare Enrolled Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910

Dr Randall Lee Ahn, PHD, MLIS - Medicare Psychologist in Fontana, CA