Jacob Poulose, MD in Northridge, CA - Medicare Internal Medicine

Jacob Poulose, MD is a medicare enrolled "Internal Medicine - Nephrology" physician in Northridge, California. His current practice location is 8349 Reseda Blvd Ste G, Northridge, California. You can reach out to his office (for appointments etc.) via phone at (818) 886-5827.

Jacob Poulose is licensed to practice in California (license number A113557) 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 1578723508.

Contact Information

	Jacob Poulose, MD
	8349 Reseda Blvd Ste G, Northridge, CA 91324-5914
	(818) 886-5827
	(818) 775-9351

Map and Direction

Physician's Profile

Full Name	Jacob Poulose
Gender	Male
Speciality	Internal Medicine - Nephrology
Location	8349 Reseda Blvd Ste G, Northridge, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1578723508
Provider Enumeration Date: 06/12/2008
Last Update Date: 01/11/2022

Medicare PECOS Information:

PECOS PAC ID: 5496942377
Enrollment ID: I20101203000796

Medical Identifiers

Medical identifiers for Jacob Poulose such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1578723508	NPI	-	NPPES
00A1135570	Medicaid	CA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	A113557 (California)	Secondary
207RN0300X	Internal Medicine - Nephrology	A113557 (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. Jacob Poulose allows following entities to bill medicare on his behalf.

Entity Name	Sohan L. Dua M.d.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1215149026 PECOS PAC ID: 3274693270 Enrollment ID: O20081120000652

Entity Name	Papr
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1295433415 PECOS PAC ID: 5092239061 Enrollment ID: O20250411000696

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. Jacob Poulose 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
Jacob Poulose, MD 8349 Reseda Blvd Ste G, Northridge, CA 91324-5914 Ph: (818) 886-5828	Jacob Poulose, MD 8349 Reseda Blvd Ste G, Northridge, CA 91324-5914 Ph: (818) 886-5827

Reviews and Comments

Internal Medicine Doctors in Northridge, CA

Dr. Fares Rabadi, M.D. Nephrology Medicare: Not Enrolled in Medicare Practice Location: 18350 Roscoe Blvd, Suite 514, Northridge, CA 91325 Phone: 818-775-0519 Fax: 818-775-0943
Dr. Masoud M Azizad, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 18433 Roscoe Blvd, #208, Northridge, CA 91325 Phone: 818-341-4401 Fax: 818-341-4402
Jean Grant Hawkins, MD FCCP Nephrology Medicare: Not Enrolled in Medicare Practice Location: 18546 Roscoe Blvd, #308, Northridge, CA 91324 Phone: 818-349-2931 Fax: 818-349-7930
Arthur Jules Lazik, M.D. Nephrology Medicare: Not Enrolled in Medicare Practice Location: 19150 Ballinger St, Northridge, CA 91324 Phone: 818-993-0508
Dr. Richard Fernando Pego, MD Nephrology Medicare: Not Enrolled in Medicare Practice Location: 17075 Devonshire Street, Suite 201, Northridge, CA 91325 Phone: 818-365-9595 Fax: 818-365-8955
George Sarka, MD, MPH, FACP, FACR Nephrology Medicare: Not Enrolled in Medicare Practice Location: 18111 Nordhoff St, Csun, Klotz Student Health Center, Northridge, CA 91330 Phone: 818-677-3666 Fax: 818-677-2304
Jerome Gary Davidson, MD Nephrology Medicare: Not Enrolled in Medicare Practice Location: 18300 Roscoe Blvd, Northridge, CA 91325 Phone: 818-700-2336 Fax: 818-700-2337

Jacob Poulose, MD - Medicare Internal Medicine in Northridge, CA