Patricia Kelleher Tynan, AGNP in Huntington Beach, CA

Patricia Kelleher Tynan, AGNP is a medicare enrolled "Nurse Practitioner - Adult Health" in Huntington Beach, California. Her current practice location is 6692 Carlow Dr, Huntington Beach, California. You can reach out to her office (for appointments etc.) via phone at (714) 791-0302.

Patricia Kelleher Tynan is licensed to practice in California (license number NP95009415) 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 1811462310.

Contact Information

	Patricia Kelleher Tynan, AGNP
	6692 Carlow Dr, Huntington Beach, CA 92647-3113
	(714) 791-0302
	(714) 289-2655

Map and Direction

Provider's Profile

Full Name	Patricia Kelleher Tynan
Gender	Female
Speciality	Nurse Practitioner - Adult Health
Location	6692 Carlow Dr, Huntington Beach, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1811462310
Provider Enumeration Date: 10/10/2018
Last Update Date: 01/15/2020

Medicare PECOS Information:

PECOS PAC ID: 4880020932
Enrollment ID: I20200207001899

Medical Identifiers

Medical identifiers for Patricia Kelleher Tynan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1811462310	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2200X	Nurse Practitioner - Adult Health	NP95009415 (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. Patricia Kelleher Tynan allows following entities to bill medicare on her behalf.

Entity Name	Providence Medical Foundation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285890624 PECOS PAC ID: 8921993205 Enrollment ID: O20040216001346

Entity Name	Primary And Multi-specialty Clinics Of Anaheim
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1053408278 PECOS PAC ID: 9638136096 Enrollment ID: O20041216000930

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. Patricia Kelleher Tynan 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
Patricia Kelleher Tynan, AGNP 6692 Carlow Dr, Huntington Beach, CA 92647-3113 Ph: (714) 791-0302	Patricia Kelleher Tynan, AGNP 6692 Carlow Dr, Huntington Beach, CA 92647-3113 Ph: (714) 791-0302

Reviews and Comments

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Patricia Kelleher Tynan, AGNP - Medicare Nurse Practitioner in Huntington Beach, CA