Mrs Kimberly Rosanne Nguyen Lopez, CNM, WHNP, RN, RD is a medicare enrolled "Advanced Practice Midwife" provider in Modesto, California. Her current practice location is
4601 Dale Rd, Modesto, California. You can reach out to her office (for appointments etc.) via phone at
(209) 735-5000.
Mrs Kimberly Rosanne Nguyen Lopez is licensed to practice in California (license number NMW236478) 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 1679950349.
Healthcare Provider's Profile
| Full Name | Mrs Kimberly Rosanne Nguyen Lopez |
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| Gender | Female |
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| Speciality | Advanced Practice Midwife |
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| Location | 4601 Dale Rd, Modesto, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1679950349
- Provider Enumeration Date: 05/01/2015
- Last Update Date: 11/13/2024
Medicare PECOS Information:
- PECOS PAC ID: 5294265898
- Enrollment ID: I20250212001257
Medical Identifiers
Medical identifiers for Mrs Kimberly Rosanne Nguyen Lopez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1679950349 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | 86043775 (California) | Secondary |
| 363LW0102X | Nurse Practitioner - Women's Health | NP95030850 (California) | Secondary |
| 367A00000X | Advanced Practice Midwife | NMW236478 (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 Kimberly Rosanne Nguyen Lopez allows following entities to bill medicare on her behalf.
| Provider Name | Permanente Medical Group Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1073606299
PECOS PAC ID: 8921910225
Enrollment ID: O20031104000710 |
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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. Mrs Kimberly Rosanne Nguyen Lopez 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 |
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Mrs Kimberly Rosanne Nguyen Lopez, CNM, WHNP, RN, RD
749 Elm St,
San Jose, CA 95126-1810
Ph: (408) 421-1086 | Mrs Kimberly Rosanne Nguyen Lopez, CNM, WHNP, RN, RD
4601 Dale Rd,
Modesto, CA 95356-9718
Ph: (209) 735-5000 |
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