Andrea Banouvong, - Medicare Nurse Practitioner in San Lorenzo, CA

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Andrea Banouvong, is a medicare enrolled "Nurse Practitioner" in San Lorenzo, California. Her current practice location is 927 Via Honda, San Lorenzo, California. You can reach out to her office (for appointments etc.) via phone at (510) 407-0749.

Andrea Banouvong is licensed to practice in California (license number 95013507) 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 1073137634.

Contact Information

Andrea Banouvong,
927 Via Honda,
San Lorenzo, CA 94580-2815
(510) 407-0749
Not Available

Map and Direction




Provider's Profile

Full NameAndrea Banouvong
GenderFemale
SpecialityNurse Practitioner
Location927 Via Honda, San Lorenzo, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1073137634
  • Provider Enumeration Date: 05/29/2020
  • Last Update Date: 05/29/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 1759768658
  • Enrollment ID: I20220516000575

Medical Identifiers

Medical identifiers for Andrea Banouvong such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1073137634NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LA2100XNurse Practitioner - Acute Care 95013507 (California)Secondary
363L00000XNurse Practitioner 95013507 (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. Andrea Banouvong allows following entities to bill medicare on her behalf.
Entity NameSutter Bay Hospitals
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1740413798
PECOS PAC ID: 3476506528
Enrollment ID: O20050517000547

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. Andrea Banouvong 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 AddressPractice Location Address
Andrea Banouvong,
927 Via Honda,
San Lorenzo, CA 94580-2815

Ph: (510) 407-0749		Andrea Banouvong,
927 Via Honda,
San Lorenzo, CA 94580-2815

Ph: (510) 407-0749

Reviews and Comments


Nurse Practitioner Nurses in San Lorenzo, CA

Ms. Karen Gold, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 50 E. Lwewlling Blvd., San Lorenzo, CA 94580
Phone: 510-317-3167    Fax: 510-276-5483
Elizabeth Gonzalez, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 50 E Lewelling Blvd, San Lorenzo, CA 94580
Phone: 510-535-4000    
Ms. Develle Williams, APRN MSN FNP BC
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 16177 Hesperian Blvd Ste C, San Lorenzo, CA 94580
Phone: 510-276-5558    Fax: 510-276-5646

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.