Nino Otacan Conde, in Lodi, CA - Medicare Physical Therapist Provider

Nino Otacan Conde, is a medicare enrolled "Physical Therapist" provider in Lodi, California. His current practice location is 631 S Ham Ln, Lodi, California. You can reach out to his office (for appointments etc.) via phone at (209) 368-7433.

Nino Otacan Conde is licensed to practice in California (license number 303521) 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 1174239172.

Contact Information

	Nino Otacan Conde,
	631 S Ham Ln, Lodi, CA 95242-3532
	(209) 368-7433
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Nino Otacan Conde
Gender	Male
Speciality	Physical Therapist
Location	631 S Ham Ln, Lodi, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1174239172
Provider Enumeration Date: 01/24/2023
Last Update Date: 01/24/2023

Medicare PECOS Information:

PECOS PAC ID: 2264804467
Enrollment ID: I20230216002931

Medical Identifiers

Medical identifiers for Nino Otacan Conde such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1174239172	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	303521 (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. Nino Otacan Conde allows following entities to bill medicare on his behalf.

Provider Name	Golden Bear Physical Therapy Sports Injury Center Inc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1811084676 PECOS PAC ID: 2961423082 Enrollment ID: O20051215000812

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. Nino Otacan Conde 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
Nino Otacan Conde, 1117 Klemeyer Cir, Stockton, CA 95206-5212 Ph: () -	Nino Otacan Conde, 631 S Ham Ln, Lodi, CA 95242-3532 Ph: (209) 368-7433

Reviews and Comments

Physical Therapist in Lodi, CA

Sharen N Cheathon, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2401 W Turner Rd, Suite 250, Lodi, CA 95242 Phone: 209-334-2224 Fax: 209-334-2225
Eliza R Downs, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2401 W Turner Rd, Suite 250, Lodi, CA 95242 Phone: 209-334-2224 Fax: 209-334-2225
Rafael Carlos, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2000 W Kettleman Ln Ste 106, Lodi, CA 95242 Phone: 209-207-0849
Piper Lee Barnes, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 631 S Ham Ln, Lodi, CA 95242 Phone: 209-368-7433 Fax: 209-368-4219
Innovative Senior Rehabilitation Services Inc. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 311 W Turner Rd, Lodi, CA 95240 Phone: 209-367-5812 Fax: 209-367-5812
Michael Ray Ballance, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 825 W Lockeford St, Lodi, CA 95240 Phone: 209-331-7471 Fax: 209-331-7464

Nino Otacan Conde, - Medicare Physical Therapist in Lodi, CA