Ms Latisha L Deyoung, CPNP-PC/AC is a medicare enrolled "Surgery - Pediatric Surgery" in Long Beach, California. Her current practice location is
2801 Atlantic Ave, Long Beach, California. You can reach out to her office (for appointments etc.) via phone at
(562) 933-1567.
Ms Latisha L Deyoung is licensed to practice in California (license number NP16256) 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 1659536688.
Provider's Profile
Full Name | Ms Latisha L Deyoung |
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Gender | Female |
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Speciality | Surgery - Pediatric Surgery |
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Location | 2801 Atlantic Ave, Long Beach, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1659536688
- Provider Enumeration Date: 07/18/2008
- Last Update Date: 08/25/2017
Medicare PECOS Information:
- PECOS PAC ID: 2769532639
- Enrollment ID: I20090615000644
Medical Identifiers
Medical identifiers for Ms Latisha L Deyoung such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1659536688 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163WP0200X | Registered Nurse - Pediatrics | 668941 (California) | Secondary |
2086S0120X | Surgery - Pediatric Surgery | NP16256 (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. Ms Latisha L Deyoung allows following entities to bill medicare on her behalf.
Entity Name | Childrens Hospital Los Angeles Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1265530653 PECOS PAC ID: 0143126920 Enrollment ID: O20031211000522 |
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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. Ms Latisha L Deyoung 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 |
Ms Latisha L Deyoung, CPNP-PC/AC 2801 Atlantic Ave, Long Beach, CA 90806-1701 Ph: (562) 933-1567 | Ms Latisha L Deyoung, CPNP-PC/AC 2801 Atlantic Ave, Long Beach, CA 90806 Ph: (562) 933-1567 |
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