Nicole Marie Sousa Santos, in Laguna Hills, CA

Nicole Marie Sousa Santos, is a medicare enrolled "Nurse Practitioner - Family" in Laguna Hills, California. Her current practice location is 3141 Moulton Pkwy, Suite 102, Laguna Hills, California. You can reach out to her office (for appointments etc.) via phone at (949) 916-9100.

Nicole Marie Sousa Santos is licensed to practice in New York (license number F349759) 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 1366169476.

Contact Information

	Nicole Marie Sousa Santos,
	3141 Moulton Pkwy, Suite 102, Laguna Hills, CA 92653
	(949) 916-9100
	Not Available

Map and Direction

Provider's Profile

Full Name	Nicole Marie Sousa Santos
Gender	Female
Speciality	Nurse Practitioner - Family
Location	3141 Moulton Pkwy, Laguna Hills, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1366169476
Provider Enumeration Date: 10/20/2022
Last Update Date: 10/20/2022

Medicare PECOS Information:

PECOS PAC ID: 2264803048
Enrollment ID: I20230116000681

Medical Identifiers

Medical identifiers for Nicole Marie Sousa Santos such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1366169476	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	F349759 (New York)	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. Nicole Marie Sousa Santos allows following entities to bill medicare on her behalf.

Entity Name	Ku Juey Raymond Chang Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1831144104 PECOS PAC ID: 6608822895 Enrollment ID: O20050330001128

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. Nicole Marie Sousa Santos 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
Nicole Marie Sousa Santos, 57 Osage St, Selden, NY 11784-2729 Ph: (631) 942-8458	Nicole Marie Sousa Santos, 3141 Moulton Pkwy, Suite 102, Laguna Hills, CA 92653 Ph: (949) 916-9100

Reviews and Comments

Nurse Practitioner Nurses in Laguna Hills, CA

Wenli Li, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 25431 Cabot Rd Ste 118, Laguna Hills, CA 92653 Phone: 949-362-8877
Mrs. Kathryn Pozzi, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 24411 Health Center Dr, Laguna Hills, CA 92653 Phone: 949-268-4568 Fax: 949-455-2795
Miss Corazon Escusa Francisco, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 23181 Verdugo Dr Ste 103a, Laguna Hills, CA 92653 Phone: 949-366-1053
Mrs. Christine Jeaneun Kim, PMHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 23141 Moulton Pkwy Ste 213, Laguna Hills, CA 92653 Phone: 949-258-3741 Fax: 949-258-3742
Michelle Rhyner, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 23183 La Cadena Dr Ste 103, Laguna Hills, CA 92653 Phone: 714-838-8188
Tiffany Ann Cervenak, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 24012 Calle De La Plata, Suite 150, Laguna Hills, CA 92653 Phone: 949-837-1578 Fax: 949-837-8154
Maryam Fathy, DNP, MSN, RN, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 24451 Health Center Dr, Laguna Hills, CA 92653 Phone: 949-424-9730 Fax: 949-452-7599

Nicole Marie Sousa Santos, - Medicare Nurse Practitioner in Laguna Hills, CA