Kenyatta Irvin, NP in Granada Hills, CA - Medicare Nurse Practitioner

Kenyatta Irvin, NP is a medicare enrolled "Nurse Practitioner" in Granada Hills, California. His current practice location is Po Box 3503, Granada Hills, California. You can reach out to his office (for appointments etc.) via phone at (000) 000-0011.

Kenyatta Irvin is licensed to practice in California (license number 95018472) 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 1689325425.

Contact Information

	Kenyatta Irvin, NP
	Po Box 3503, Granada Hills, CA 91394-0503
	(000) 000-0011
	Not Available

Map and Direction

Provider's Profile

Full Name	Kenyatta Irvin
Gender	Male
Speciality	Nurse Practitioner
Location	Po Box 3503, Granada Hills, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1689325425
Provider Enumeration Date: 01/13/2022
Last Update Date: 03/20/2025

Medicare PECOS Information:

PECOS PAC ID: 8820442460
Enrollment ID: I20230929002066

Medical Identifiers

Medical identifiers for Kenyatta Irvin such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1689325425	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	95018472 (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. Kenyatta Irvin allows following entities to bill medicare on his behalf.

Entity Name	Valley Tumor Medical Group A Medical Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366584948 PECOS PAC ID: 8820045966 Enrollment ID: O20050725001250

Entity Name	City Of Hope Medical Foundation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1871886366 PECOS PAC ID: 3779751656 Enrollment ID: O20110720000244

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. Kenyatta Irvin 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
Kenyatta Irvin, NP Po Box 3503, Granada Hills, CA 91394-0503 Ph: () -	Kenyatta Irvin, NP Po Box 3503, Granada Hills, CA 91394-0503 Ph: (000) 000-0011

Reviews and Comments

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Kenyatta Irvin, NP - Medicare Nurse Practitioner in Granada Hills, CA