Mr James David Killeen Iii, MD in Fontana, CA

Mr James David Killeen Iii, MD is a medicare enrolled "Pediatrics" physician in Fontana, California. His current practice location is 9961 Sierra Ave, Kaiser Permanente Fontana - Pediatrics, Fontana, California. You can reach out to his office (for appointments etc.) via phone at (909) 427-6960.

Mr James David Killeen Iii is licensed to practice in California (license number A126081) 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 1003100579.

Contact Information

	Mr James David Killeen Iii, MD
	9961 Sierra Ave, Kaiser Permanente Fontana - Pediatrics, Fontana, CA 92335-6720
	(909) 427-6960
	Not Available

Map and Direction

Physician's Profile

Full Name	Mr James David Killeen Iii
Gender	Male
Speciality	Pediatrics
Location	9961 Sierra Ave, Fontana, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1003100579
Provider Enumeration Date: 06/02/2011
Last Update Date: 12/03/2021

Medicare PECOS Information:

PECOS PAC ID: 7113148362
Enrollment ID: I20141031001539

Medical Identifiers

Medical identifiers for Mr James David Killeen Iii such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1003100579	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	A126081 (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. Mr James David Killeen Iii allows following entities to bill medicare on his behalf.

Entity Name	Southern California Permanente Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823

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. Mr James David Killeen Iii 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
Mr James David Killeen Iii, MD 393 E Walnut St, Phr Group Provider Enrollment Unit 3rd Fl, Pasadena, CA 91188-0001 Ph: (877) 608-0044	Mr James David Killeen Iii, MD 9961 Sierra Ave, Kaiser Permanente Fontana - Pediatrics, Fontana, CA 92335-6720 Ph: (909) 427-6960

Reviews and Comments

Pediatrics Doctors in Fontana, CA

Ramandeep Kaur, M.D Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 16465 Sierra Lakes Pkwy Ste 115, Fontana, CA 92336 Phone: 909-823-8000 Fax: 909-823-8088
Leslie Sison Aquino-peralta, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910
Connie Lew Cheng, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910
Miss Irene H Odom, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-5451
Mrs. Emma Claire Boda, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 16465 Sierra Lakes Pkwy Ste 115, Fontana, CA 92336 Phone: 909-823-8000 Fax: 909-823-8088
Eric Mun-kong Wong, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910

Mr James David Killeen Iii, MD - Medicare Pediatrics in Fontana, CA