Mr James David Killeen Iii, MD - Medicare Pediatrics in Fontana, CA

Mr James David Killeen Iii, MD is a medicare enrolled "Pediatrics" physician in Fontana, California. His current practice location is 9961 Sierra Ave, Kaiser Permanente Fontana - Pediatrics, Fontana, California. You can reach out to his office (for appointments etc.) via phone at (909) 427-6960.

Mr James David Killeen Iii is licensed to practice in California (license number A126081) 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 1003100579.

Contact Information

Mr James David Killeen Iii, MD
9961 Sierra Ave, Kaiser Permanente Fontana - Pediatrics,
Fontana, CA 92335-6720
(909) 427-6960
Not Available



Physician's Profile

Full NameMr James David Killeen Iii
GenderMale
SpecialityPediatrics
Location9961 Sierra Ave, Fontana, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1003100579
  • Provider Enumeration Date: 06/02/2011
  • Last Update Date: 12/03/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 7113148362
  • Enrollment ID: I20141031001539

Medical Identifiers

Medical identifiers for Mr James David Killeen Iii such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003100579NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics A126081 (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. Mr James David Killeen Iii allows following entities to bill medicare on his behalf.
Entity NameSouthern California Permanente Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1316979834
PECOS PAC ID: 6002729175
Enrollment ID: O20040126000823

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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. Mr James David Killeen Iii 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 AddressPractice Location Address
Mr James David Killeen Iii, MD
393 E Walnut St, Phr Group Provider Enrollment Unit 3rd Fl,
Pasadena, CA 91188-0001

Ph: (877) 608-0044
Mr James David Killeen Iii, MD
9961 Sierra Ave, Kaiser Permanente Fontana - Pediatrics,
Fontana, CA 92335-6720

Ph: (909) 427-6960

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Pediatrics Doctors in Fontana, CA

Ramandeep Kaur, M.D
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 16465 Sierra Lakes Pkwy Ste 115, Fontana, CA 92336
Phone: 909-823-8000    Fax: 909-823-8088
Leslie Sison Aquino-peralta, MD
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 9961 Sierra Ave, Fontana, CA 92335
Phone: 909-427-3910    
Connie Lew Cheng, DO
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 9961 Sierra Ave, Fontana, CA 92335
Phone: 909-427-3910    
Miss Irene H Odom, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 9961 Sierra Ave, Fontana, CA 92335
Phone: 909-427-5451    
Mrs. Emma Claire Boda,
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 16465 Sierra Lakes Pkwy Ste 115, Fontana, CA 92336
Phone: 909-823-8000    Fax: 909-823-8088
Eric Mun-kong Wong, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 9961 Sierra Ave, Fontana, CA 92335
Phone: 909-427-3910    

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