Samantha Gonzalez, is a medicare enrolled "Student In An Organized Health Care Education/training Program" provider in Los Angeles, California. Her current practice location is
1000 Veteran Ave, Los Angeles, California. You can reach out to her office (for appointments etc.) via phone at
(323) 524-8280.
Samantha Gonzalez is licensed to practice in * (Not Available) (license number ) 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 1811563281.
Healthcare Provider's Profile
Full Name | Samantha Gonzalez |
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Gender | Female |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 1000 Veteran Ave, Los Angeles, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1811563281
- Provider Enumeration Date: 05/27/2021
- Last Update Date: 07/10/2023
Medicare PECOS Information:
- PECOS PAC ID: 8022454669
- Enrollment ID: I20240306001223
Medical Identifiers
Medical identifiers for Samantha Gonzalez such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1811563281 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103TC0700X | Psychologist - Clinical | WAIVERED (California) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (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. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Samantha Gonzalez allows following entities to bill medicare on her behalf.
Entity Name | Permanente Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
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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. Samantha Gonzalez 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 |
Samantha Gonzalez, 1000 Veteran Ave, Los Angeles, CA 90024-2704 Ph: () - | Samantha Gonzalez, 1000 Veteran Ave, Los Angeles, CA 90024-2704 Ph: (323) 524-8280 |
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