Tamisha P Gilmore, in Victorville, CA - Medicare Nurse Practitioner

Tamisha P Gilmore, is a medicare enrolled "Nurse Practitioner - Family" in Victorville, California. Her current practice location is 16798 Desert Star St, Victorville, California. You can reach out to her office (for appointments etc.) via phone at (909) 240-3366.

Tamisha P Gilmore is licensed to practice in California (license number 95029418) 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 1407605819.

Contact Information

	Tamisha P Gilmore,
	16798 Desert Star St, Victorville, CA 92394-1466
	(909) 240-3366
	Not Available

Map and Direction

Provider's Profile

Full Name	Tamisha P Gilmore
Gender	Female
Speciality	Nurse Practitioner - Family
Location	16798 Desert Star St, Victorville, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1407605819
Provider Enumeration Date: 05/16/2024
Last Update Date: 09/26/2024

Medicare PECOS Information:

PECOS PAC ID: 3971044520
Enrollment ID: I20240923001897

Medical Identifiers

Medical identifiers for Tamisha P Gilmore such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1407605819	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	95029418 (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. Tamisha P Gilmore allows following entities to bill medicare on her behalf.

Entity Name	Providence Medical Foundation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285890624 PECOS PAC ID: 8921993205 Enrollment ID: O20040216001346

Entity Name	Tobias Moeller-bertram Md Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1922440684 PECOS PAC ID: 1456586064 Enrollment ID: O20140128000459

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. Tamisha P Gilmore 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
Tamisha P Gilmore, 16798 Desert Star St, Victorville, CA 92394-1466 Ph: (909) 240-3366	Tamisha P Gilmore, 16798 Desert Star St, Victorville, CA 92394-1466 Ph: (909) 240-3366

Reviews and Comments

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Tamisha P Gilmore, - Medicare Nurse Practitioner in Victorville, CA