Marilyn Tadiaman Pudol, in El Segundo, CA - Medicare Nurse Practitioner

Marilyn Tadiaman Pudol, is a medicare enrolled "Nurse Practitioner - Family" in El Segundo, California. Her current practice location is 2101 Rosecrans Ave # 3230, El Segundo, California. You can reach out to her office (for appointments etc.) via phone at (323) 628-8671.

Marilyn Tadiaman Pudol is licensed to practice in California (license number 95008725) 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 1720573439.

Contact Information

	Marilyn Tadiaman Pudol,
	2101 Rosecrans Ave # 3230, El Segundo, CA 90245-4749
	(323) 628-8671
	Not Available

Map and Direction

Provider's Profile

Full Name	Marilyn Tadiaman Pudol
Gender	Female
Speciality	Nurse Practitioner - Family
Location	2101 Rosecrans Ave # 3230, El Segundo, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1720573439
Provider Enumeration Date: 06/25/2018
Last Update Date: 10/24/2019

Medicare PECOS Information:

PECOS PAC ID: 2062754856
Enrollment ID: I20190426000746

Medical Identifiers

Medical identifiers for Marilyn Tadiaman Pudol such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1720573439	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	95008725 (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. Marilyn Tadiaman Pudol allows following entities to bill medicare on her behalf.

Entity Name	Care Connect Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1134669971 PECOS PAC ID: 8628352747 Enrollment ID: O20170308001642

Entity Name	Concertocare Medical Group Of California Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1922777259 PECOS PAC ID: 1850782186 Enrollment ID: O20211221002909

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. Marilyn Tadiaman Pudol 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
Marilyn Tadiaman Pudol, 3056 Fletcher Dr, Los Angeles, CA 90065-2207 Ph: (323) 256-2231	Marilyn Tadiaman Pudol, 2101 Rosecrans Ave # 3230, El Segundo, CA 90245-4749 Ph: (323) 628-8671

Reviews and Comments

Nurse Practitioner Nurses in El Segundo, CA

Kenn Rafanan, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2101 Rosecrans Ave # 3230, El Segundo, CA 90245 Phone: 323-628-8671
Megan Puyau, PMHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 390 N Pacific Coast Hwy Ste 2060, El Segundo, CA 90245 Phone: 855-427-2778 Fax: 424-277-6085
Young Shin, N.P. Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2101 Rosecrans Ave # 3230, El Segundo, CA 90245 Phone: 323-628-8671
Rodel Lumanog, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2101 Rosecrans Ave # 3230, El Segundo, CA 90245 Phone: 323-628-8671
Taylor Cwiertniewicz, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2101 Rosecrans Ave # 3230, El Segundo, CA 90245 Phone: 323-628-8671
Victoria Desimone, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 222 N Pacific Coast Hwy Ste 2175, El Segundo, CA 90245 Phone: 877-878-3289
Monica Casado Liyanage, NURSE PRACTITIONER Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2175 Park Pl, El Segundo, CA 90245 Phone: 310-345-4200

Marilyn Tadiaman Pudol, - Medicare Nurse Practitioner in El Segundo, CA