Dr John Keith Nylund, MD is a medicare enrolled "Dermatology" physician in Hawthorne, California. His current practice location is
14650 Aviation Blvd, Suite 235, Hawthorne, California. You can reach out to his office (for appointments etc.) via phone at
(310) 643-9333.
Dr John Keith Nylund is licensed to practice in California (license number CO34111) 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 1407029069.
Physician's Profile
| Full Name | Dr John Keith Nylund |
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| Gender | Male |
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| Speciality | Dermatology |
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| Location | 14650 Aviation Blvd, Hawthorne, 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: 1407029069
- Provider Enumeration Date: 04/03/2008
- Last Update Date: 09/25/2008
Medicare PECOS Information:
- PECOS PAC ID: 6507924180
- Enrollment ID: I20081027000307
Medical Identifiers
Medical identifiers for Dr John Keith Nylund such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1407029069 | NPI | - | NPPES |
| WWH7CB | Other | CA | PASSWORD FOR PALMETTO |
| CO34111 | Other | CA | STATE MEDICAL LISCECE |
| W9243 | Other | CA | PPTAN # |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207N00000X | Dermatology | CO34111 (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 John Keith Nylund allows following entities to bill medicare on his behalf.
| Entity Name | John K Nylund Md Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1811949902
PECOS PAC ID: 7012982911
Enrollment ID: O20081027000331 |
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| Entity Name | Wu Enterprise Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1881352581
PECOS PAC ID: 5193113090
Enrollment ID: O20211026002336 |
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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 John Keith Nylund 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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Dr John Keith Nylund, MD
14650 Aviation Blvd, Suite 235,
Hawthorne, CA 90250-6668
Ph: (310) 643-9333 | Dr John Keith Nylund, MD
14650 Aviation Blvd, Suite 235,
Hawthorne, CA 90250-6656
Ph: (310) 643-9333 |
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