Ivonne De Carlo Fuller, MS in Baldwin Park, CA - Medicare Speech-Language Pathologist Provider

Ivonne De Carlo Fuller, MS is a medicare enrolled "Speech-language Pathologist" provider in Baldwin Park, California. Her current practice location is 1011 Baldwin Park Blvd, Baldwin Park, California. You can reach out to her office (for appointments etc.) via phone at (626) 851-6671.

Ivonne De Carlo Fuller is licensed to practice in California (license number 20326) 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 1679859631.

Contact Information

	Ivonne De Carlo Fuller, MS
	1011 Baldwin Park Blvd, Baldwin Park, CA 91706-5806
	(626) 851-6671
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Ivonne De Carlo Fuller
Gender	Female
Speciality	Speech-language Pathologist
Location	1011 Baldwin Park Blvd, Baldwin Park, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1679859631
Provider Enumeration Date: 10/21/2011
Last Update Date: 12/16/2021

Medicare PECOS Information:

PECOS PAC ID: 7810156130
Enrollment ID: I20120306000742

Medical Identifiers

Medical identifiers for Ivonne De Carlo Fuller such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1679859631	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
235Z00000X	Speech-language Pathologist	20326 (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. Ivonne De Carlo Fuller allows following entities to bill medicare on her behalf.

Provider Name	Southern California Permanente Medical Group
Provider Type	Part B Supplier - Clinic/group Practice
Provider 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. Ivonne De Carlo Fuller 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
Ivonne De Carlo Fuller, MS 14008 Rockenbach St, Baldwin Park, CA 91706-2463 Ph: (818) 601-7644	Ivonne De Carlo Fuller, MS 1011 Baldwin Park Blvd, Baldwin Park, CA 91706-5806 Ph: (626) 851-6671

Reviews and Comments

Speech-Language Pathologist in Baldwin Park, CA

Kendra Crumbacher, M.S. CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 14148 Francisquito Ave, Baldwin Park, CA 91706 Phone: 626-388-2700
Joyce C Young, SP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1011 Baldwin Park Blvd, Baldwin Park, CA 91706 Phone: 626-851-1011 Fax: 626-405-6768
Katherine M Moeller, SP Speech-Language Pathologist Medicare: Accepting Medicare Assignments Practice Location: 1011 Baldwin Park Blvd, Baldwin Park, CA 91706 Phone: 626-851-1011
Sumner L Blanchard, SP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 1011 Baldwin Park Blvd, Baldwin Park, CA 91706 Phone: 626-851-1011 Fax: 626-405-6768
Lorraine A Morgan, SP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 1011 Baldwin Park Blvd, Baldwin Park, CA 91706 Phone: 626-851-1011 Fax: 626-405-6768
Selvarani Venugopal, SPEECH THERAPIST Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 14318 Ohio St, Baldwin Park, CA 91706 Phone: 626-960-1971

Ivonne De Carlo Fuller, MS - Medicare Speech-Language Pathologist in Baldwin Park, CA