Noble Community Medical Assocaites is a medicare enrolled "Family Medicine" provider in Reseda, California. Their current practice location is
17750 Sherman Way, Ste 101, Reseda, California. You can reach out to their office (for appointments etc.) via phone at
(818) 705-7200.
Noble Community Medical Assocaites is licensed to practice in California (license number A36588) and it also participates in the medicare program. Noble Community Medical Assocaites
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1114947058.
Healthcare Provider's Profile
| Full Name | Noble Community Medical Assocaites |
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| Type | Facility |
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| Speciality | Family Medicine |
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| Location | 17750 Sherman Way, Reseda, California |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1114947058
- Provider Enumeration Date: 07/21/2006
- Last Update Date: 05/29/2008
Medicare PECOS Information:
- PECOS PAC ID: 3476508979
- Enrollment ID: O20050317000511
Medical Identifiers
Medical identifiers for Noble Community Medical Assocaites such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1114947058 | NPI | - | NPPES |
| ZZZ50145Z | Other | CA | BLUE SHEILD (RESEDA) |
| ZZZ50147Z | Other | CA | BLUE SHEILD (INGLEWOOD) |
| ZZZ50174Z | Other | CA | BLUE SHEILD (S.B.) |
| ZZZ50176Z | Other | CA | BLUE SHEILD (C.P) |
| ZZZ501722Z | Other | CA | BLUE SHEILD (G.H.) |
| ZZZ50172Z | Other | CA | BLUE SHEILD (EL MONTE) |
| ZZZ50173Z | Other | CA | BLUE SHEILD (PASADENA) |
| GR0102431 | Medicaid | CA | |
| GR0102433 | Medicaid | CA | |
| ZZZ50146Z | Other | CA | BLUE SHEILD (L.A.) |
| GR0102434 | Medicaid | CA | |
| ZZZ501752 | Other | CA | BLUE SHEILD |
| GR0102430 | Medicaid | CA | |
| GR0102432 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | DC21916 (California) | Secondary |
| 111N00000X | Chiropractor | DC28504 (California) | Secondary |
| 111N00000X | Chiropractor | DC20140 (California) | Secondary |
| 111N00000X | Chiropractor | DC20098 (California) | Secondary |
| 173F00000X | Sleep Specialist, Phd | 173F00000X (California) | Secondary |
| 207Q00000X | Family Medicine | A36588 (California) | Primary |
| 207Q00000X | Family Medicine | A35585 (California) | Secondary |
| 207R00000X | Internal Medicine | A64420 (California) | Secondary |
| 207R00000X | Internal Medicine | A44927 (California) | Secondary |
| 207X00000X | Orthopaedic Surgery | C30241 (California) | Secondary |
| 207X00000X | Orthopaedic Surgery | C31379 (California) | Secondary |
| 208000000X | Pediatrics | A25062 (California) | Secondary |
| 208000000X | Pediatrics | A54207 (California) | Secondary |
| 208VP0000X | Pain Medicine - Pain Medicine | G78404 (California) | Secondary |
| 363A00000X | Physician Assistant | PA13428 (California) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Noble Community Medical Assocaites acts as a billing entity for following providers:
| Provider Name | Michael M Koshak |
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| Provider Type | Practitioner - General Practice |
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| Provider Identifiers | NPI Number: 1689680696
PECOS PAC ID: 9537187208
Enrollment ID: I20051110000883 |
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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. Noble Community Medical Assocaites 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 |
|---|
Noble Community Medical Assocaites
17750 Sherman Way, Ste 101,
Reseda, CA 91335-3380
Ph: (818) 705-7200 | Noble Community Medical Assocaites
17750 Sherman Way, Ste 101,
Reseda, CA 91335-3380
Ph: (818) 705-7200 |
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