Tararoth Pen Keo, in Lancaster, CA - Medicare Nurse Practitioner

Tararoth Pen Keo, is a medicare enrolled "Nurse Practitioner - Family" in Lancaster, California. Her current practice location is 43932 15th St W Ste 103, Lancaster, California. You can reach out to her office (for appointments etc.) via phone at (661) 945-7755.

Tararoth Pen Keo is licensed to practice in California (license number 95029648) 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 1205689783.

Contact Information

	Tararoth Pen Keo,
	43932 15th St W Ste 103, Lancaster, CA 93534-5234
	(661) 945-7755
	Not Available

Map and Direction

Provider's Profile

Full Name	Tararoth Pen Keo
Gender	Female
Speciality	Nurse Practitioner - Family
Location	43932 15th St W Ste 103, Lancaster, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1205689783
Provider Enumeration Date: 04/08/2024
Last Update Date: 04/08/2024

Medicare PECOS Information:

PECOS PAC ID: 1850816927
Enrollment ID: I20250422000831

Medical Identifiers

Medical identifiers for Tararoth Pen Keo such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1205689783	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	95029648 (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. Tararoth Pen Keo allows following entities to bill medicare on her behalf.

Entity Name	Unified Health Associates
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1326773672 PECOS PAC ID: 0749664910 Enrollment ID: O20220907002679

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. Tararoth Pen Keo 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
Tararoth Pen Keo, 1134 Brianna Ave, Lancaster, CA 93535-2931 Ph: (661) 902-3369	Tararoth Pen Keo, 43932 15th St W Ste 103, Lancaster, CA 93534-5234 Ph: (661) 945-7755

Reviews and Comments

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Tararoth Pen Keo, - Medicare Nurse Practitioner in Lancaster, CA