Dr Gordon E Van Tassell, DO is a medicare enrolled "Family Medicine" physician in Hollywood, California. His current practice location is
1300 N La Brea Ave, Hollywood, California. You can reach out to his office (for appointments etc.) via phone at
(323) 464-1336.
Dr Gordon E Van Tassell is licensed to practice in California (license number 20A6929) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1104864024.
Physician's Profile
| Full Name | Dr Gordon E Van Tassell |
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| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 1300 N La Brea Ave, Hollywood, 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: 1104864024
- Provider Enumeration Date: 06/03/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 6103183488
- Enrollment ID: I20171121001599
Medical Identifiers
Medical identifiers for Dr Gordon E Van Tassell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1104864024 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 20A6929 (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. Dr Gordon E Van Tassell allows following entities to bill medicare on his behalf.
| Entity Name | Anaheim Urgent Care Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1962680033
PECOS PAC ID: 8325118029
Enrollment ID: O20080606000728 |
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| Entity Name | Exer Medical Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1588901532
PECOS PAC ID: 9032359534
Enrollment ID: O20130705000153 |
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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. Dr Gordon E Van Tassell 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 |
|---|
Dr Gordon E Van Tassell, DO
1300 N La Brea Ave,
Hollywood, CA 90028-7504
Ph: (323) 464-1336 | Dr Gordon E Van Tassell, DO
1300 N La Brea Ave,
Hollywood, CA 90028-7504
Ph: (323) 464-1336 |
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