Mrs Shayma Mortazavi, MFT in Riverside, CA - Medicare Marriage & Family Therapist Provider

Mrs Shayma Mortazavi, MFT is a medicare enrolled "Marriage & Family Therapist" provider in Riverside, California. Her current practice location is 5225 Canyon Crest Dr Bldg 100, Riverside, California. You can reach out to her office (for appointments etc.) via phone at (951) 248-4000.

Mrs Shayma Mortazavi is licensed to practice in California (license number LMFT80323) 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 1629315098.

Contact Information

	Mrs Shayma Mortazavi, MFT
	5225 Canyon Crest Dr Bldg 100, Riverside, CA 92507-6301
	(951) 248-4000
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Shayma Mortazavi
Gender	Female
Speciality	Marriage & Family Therapist
Location	5225 Canyon Crest Dr Bldg 100, Riverside, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1629315098
Provider Enumeration Date: 01/05/2013
Last Update Date: 11/18/2021

Medicare PECOS Information:

PECOS PAC ID: 3476099599
Enrollment ID: I20240725002020

Medical Identifiers

Medical identifiers for Mrs Shayma Mortazavi such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1629315098	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
106H00000X	Marriage & Family Therapist	LMFT80323 (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. Mrs Shayma Mortazavi allows following entities to bill medicare on her behalf.

Entity Name	Southern California Permanente Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823

Entity Name	Sud Specialty Group - Ca
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1972138238 PECOS PAC ID: 9537534177 Enrollment ID: O20230412001370

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. Mrs Shayma Mortazavi 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
Mrs Shayma Mortazavi, MFT 5225 Canyon Crest Dr Bldg 100, Riverside, CA 92507-6301 Ph: (951) 248-4000	Mrs Shayma Mortazavi, MFT 5225 Canyon Crest Dr Bldg 100, Riverside, CA 92507-6301 Ph: (951) 248-4000

Reviews and Comments

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