Prudence Ticknor, RD in Modesto, CA - Medicare Registered Dietitian Or Nutrition Professional Provider

Prudence Ticknor, RD is a medicare enrolled "Dietitian, Registered" provider in Modesto, California. She graduated from medical school in 1997 and has 27 years of diverse experience with area of expertise as Registered Dietitian Or Nutrition Professional. She is a member of the group practice Central California Bariatric Surgery A Medical Corporation and her current practice location is 1552 Coffee Rd, Suite 200, Modesto, California. You can reach out to her office (for appointments etc.) via phone at (209) 248-7168.

Prudence Ticknor is licensed to practice in North Carolina (license number 819773) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1174920821.

Contact Information

	Prudence Ticknor, RD
	1552 Coffee Rd, Suite 200, Modesto, CA 95355-3122
	(209) 248-7168
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Prudence Ticknor
Gender	Female
Speciality	Registered Dietitian Or Nutrition Professional
Experience	27 Years
Location	1552 Coffee Rd, Modesto, California
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Prudence Ticknor graduated from medical school in 1997

NPI Data:

NPI Number: 1174920821
Provider Enumeration Date: 11/24/2014
Last Update Date: 03/21/2017

Medicare PECOS Information:

PECOS PAC ID: 4688938483
Enrollment ID: I20180502002366

Medical Identifiers

Medical identifiers for Prudence Ticknor such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1174920821	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
133V00000X	Dietitian, Registered	819773 (North Carolina)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Central California Bariatric Surgery A Medical Corporation	0547289423	10

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. Prudence Ticknor allows following entities to bill medicare on her behalf.

Provider Name	Central California Bariatric Surgery A Medical Corporation
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1124141163 PECOS PAC ID: 0547289423 Enrollment ID: O20051121000631

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. Prudence Ticknor 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
Prudence Ticknor, RD 1552 Coffee Rd, Suite 200, Modesto, CA 95355-3122 Ph: (209) 248-7168	Prudence Ticknor, RD 1552 Coffee Rd, Suite 200, Modesto, CA 95355-3122 Ph: (209) 248-7168

Reviews and Comments

Dietitian, Registered in Modesto, CA

Be Food Wise Dietitian Medicare: Not Enrolled in Medicare Practice Location: 931 10th St Ste 771, Modesto, CA 95354 Phone: 209-771-4717
Beth Goodridge, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 931 10th St Ste 771, Modesto, CA 95354 Phone: 209-771-4717
Mireille Salib, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 4601 Dale Rd, Modesto, CA 95356 Phone: 209-735-5000
Lauren Renee Pavlov, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1441 Florida Ave, Modesto, CA 95350 Phone: 209-578-1211
Micah S Bautista, RDN Dietitian Medicare: Medicare Enrolled Practice Location: 600 Coffee Rd, Modesto, CA 95355 Phone: 209-550-4747
Amanda Johnson, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 4601 Dale Rd, Modesto, CA 95356 Phone: 209-735-5086
Megan Mirza, RD Dietitian Medicare: Medicare Enrolled Practice Location: 600 Coffee Rd, Modesto, CA 95355 Phone: 209-550-4747

Prudence Ticknor, RD - Medicare Dietitian in Modesto, CA