Ladan Modallel, MD in San Bernardino, CA

Ladan Modallel, MD is a medicare enrolled "Pediatrics" physician in San Bernardino, California. Her current practice location is 1574 W Base Line St Ste 107, San Bernardino, California. You can reach out to her office (for appointments etc.) via phone at (909) 386-1880.

Ladan Modallel is licensed to practice in Washington (license number MD60914735) 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 1669633376.

Contact Information

	Ladan Modallel, MD
	1574 W Base Line St Ste 107, San Bernardino, CA 92411-1736
	(909) 386-1880
	(909) 386-1882

Map and Direction

Physician's Profile

Full Name	Ladan Modallel
Gender	Female
Speciality	Pediatrics
Location	1574 W Base Line St Ste 107, San Bernardino, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1669633376
Provider Enumeration Date: 06/24/2008
Last Update Date: 03/07/2023

Medicare PECOS Information:

PECOS PAC ID: 7416115878
Enrollment ID: I20141210001414

Medical Identifiers

Medical identifiers for Ladan Modallel such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1669633376	NPI	-	NPPES
2122359	Medicaid	WA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	117285 (California)	Secondary
208000000X	Pediatrics	44915 (Kentucky)	Secondary
208000000X	Pediatrics	MD60914735 (Washington)	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. Ladan Modallel allows following entities to bill medicare on her behalf.

Entity Name	Community Health Centers Of The Central Coast Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1336166248 PECOS PAC ID: 7416868120 Enrollment ID: O20040115001161

Entity Name	Golden Valley Health Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1356445753 PECOS PAC ID: 4183527187 Enrollment ID: O20040128000641

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. Ladan Modallel 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
Ladan Modallel, MD 742 W Highland Ave, San Bernardino, CA 92405-3839 Ph: (909) 386-1880	Ladan Modallel, MD 1574 W Base Line St Ste 107, San Bernardino, CA 92411-1736 Ph: (909) 386-1880

Reviews and Comments

Pediatrics Doctors in San Bernardino, CA

Dr. Kofi Adade-boafo, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2150 N Waterman Ave, Ste 200, San Bernardino, CA 92404 Phone: 909-887-7951 Fax: 909-883-1634
Dr. Irene Styadi Tsai, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 685 Carnegie Dr, Ste. #230, San Bernardino, CA 92408 Phone: 909-890-0407
Swapna S. Kudtarkar, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 401 E Highland Ave Ste 450a, San Bernardino, CA 92404 Phone: 909-864-4700 Fax: 909-883-0459
Angie Bagheri Cook, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 565 N. Mount Vernon Ave, San Bernardino, CA 92411 Phone: 909-884-9091
Mrs. Amal Shoukry Ibrahim, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 565 N. Mt. Vernon Ave, San Bernardino, CA 92411 Phone: 909-884-9091 Fax: 909-383-7013
Ms. Lanny Nizar, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2101 N Waterman Ave, San Bernardino, CA 92404 Phone: 909-881-4315 Fax: 909-881-4474
Dr. Mohammad S Kanakriyeh, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 350 E Vanderbilt Way, Ste A, San Bernardino, CA 92408 Phone: 909-886-5200 Fax: 909-382-9017

Ladan Modallel, MD - Medicare Pediatrics in San Bernardino, CA