Jackline Wanga Gates, in Lake Elsinore, CA - Medicare Nurse Practitioner

Jackline Wanga Gates, is a medicare enrolled "Nurse Practitioner" in Lake Elsinore, California. Her current practice location is 30195 Fraser Dr, Lake Elsinore, California. You can reach out to her office (for appointments etc.) via phone at (951) 252-2720.

Jackline Wanga Gates is licensed to practice in California (license number 95013168) 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 1801432216.

Contact Information

	Jackline Wanga Gates,
	30195 Fraser Dr, Lake Elsinore, CA 92530-7006
	(951) 252-2720
	Not Available

Map and Direction

Provider's Profile

Full Name	Jackline Wanga Gates
Gender	Female
Speciality	Nurse Practitioner
Location	30195 Fraser Dr, Lake Elsinore, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1801432216
Provider Enumeration Date: 11/20/2019
Last Update Date: 09/13/2021

Medicare PECOS Information:

PECOS PAC ID: 4587077375
Enrollment ID: I20220907001656

Medical Identifiers

Medical identifiers for Jackline Wanga Gates such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1801432216	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	95013168 (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. Jackline Wanga Gates allows following entities to bill medicare on her behalf.

Entity Name	Peachtree Immediate Care Fp, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1437194156 PECOS PAC ID: 3274559323 Enrollment ID: O20051019000049

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. Jackline Wanga Gates 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
Jackline Wanga Gates, 1000 Vale Terrace Dr, Vista, CA 92084-5218 Ph: (760) 631-5000	Jackline Wanga Gates, 30195 Fraser Dr, Lake Elsinore, CA 92530-7006 Ph: (951) 252-2720

Reviews and Comments

Nurse Practitioner Nurses in Lake Elsinore, CA

Vladimir Aguilar, ACNPC-AG Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 29430 Linden Pl, Lake Elsinore, CA 92530 Phone: 951-452-3202
Mrs. Andrea Arthur, N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 31739 Riverside Dr Ste A1, Lake Elsinore, CA 92530 Phone: 951-245-0505
Edil Evangelista, MSN RN PHN FNPC CCRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 425 Diamond Dr Ste 105, Lake Elsinore, CA 92530 Phone: 951-674-8779
Gina Michelle Musolino, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 29416 Rocky Canyon Dr, Lake Elsinore, CA 92530 Phone: 909-921-5904
Mayra Leticia Padilla Arechiga, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 141 N Main St, Lake Elsinore, CA 92530 Phone: 855-505-7467
Ms. Abigail Coiner, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 425 Diamond Dr, Lake Elsinore, CA 92530 Phone: 951-674-4114
Laura Macias-el Yamany, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 15071 Heather Ln, Lake Elsinore, CA 92530 Phone: 562-201-2304

Jackline Wanga Gates, - Medicare Nurse Practitioner in Lake Elsinore, CA