Kolleen Paradise, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Altadena, California. Her current practice location is
835 E. Calaveras St., Altadena, California. You can reach out to her office (for appointments etc.) via phone at
(619) 405-2521.
Kolleen Paradise is licensed to practice in California (license number 3989) 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 1821313321.
Provider's Profile
| Full Name | Kolleen Paradise |
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| Gender | Female |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 835 E. Calaveras St., Altadena, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1821313321
- Provider Enumeration Date: 03/29/2010
- Last Update Date: 02/07/2012
Medicare PECOS Information:
- PECOS PAC ID: 6608057146
- Enrollment ID: I20120328000309
Medical Identifiers
Medical identifiers for Kolleen Paradise such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1821313321 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | RN60188819 (Washington) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 3989 (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. Kolleen Paradise allows following entities to bill medicare on her behalf.
| Entity Name | Amsurg South Bay Anesthesia Lp |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1811230022
PECOS PAC ID: 4082853411
Enrollment ID: O20130617000101 |
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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. Kolleen Paradise 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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Kolleen Paradise,
43 1/2 Thornton Ave,
Venice, CA 90291-3110
Ph: (619) 405-2521 | Kolleen Paradise,
835 E. Calaveras St.,
Altadena, CA 91001
Ph: (619) 405-2521 |
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