Mrs Maryam Modirrousta, CNM, NP - Medicare Advanced Practice Midwife in Apple Valley, CA

Mrs Maryam Modirrousta, CNM, NP is a medicare enrolled "Advanced Practice Midwife" in Apple Valley, California. Her current practice location is 18300 Us Highway 18, Apple Valley, California. You can reach out to her office (for appointments etc.) via phone at (706) 242-2311.

Mrs Maryam Modirrousta is licensed to practice in California (license number NMW1949) 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 1548514565.

Contact Information

Mrs Maryam Modirrousta, CNM, NP
18300 Us Highway 18,
Apple Valley, CA 92307-2206
(706) 242-2311
(760) 946-8875



Provider's Profile

Full NameMrs Maryam Modirrousta
GenderFemale
SpecialityAdvanced Practice Midwife
Location18300 Us Highway 18, Apple Valley, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1548514565
  • Provider Enumeration Date: 10/29/2012
  • Last Update Date: 12/08/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 2769704790
  • Enrollment ID: I20141202002419

Medical Identifiers

Medical identifiers for Mrs Maryam Modirrousta such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1548514565NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367A00000XAdvanced Practice Midwife NMW1949 (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. Mrs Maryam Modirrousta allows following entities to bill medicare on her 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. Mrs Maryam Modirrousta 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
Mrs Maryam Modirrousta, CNM, NP
18300 Us Highway 18,
Apple Valley, CA 92307-2206

Ph: (706) 242-2311
Mrs Maryam Modirrousta, CNM, NP
18300 Us Highway 18,
Apple Valley, CA 92307-2206

Ph: (706) 242-2311

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Advanced Practice Midwife Nurses in Apple Valley, CA

Ms. Kimberly Kay Tillotson, CNM/NP
Advanced Practice Midwife
Medicare: Not Enrolled in Medicare
Practice Location: 18300 Highway 18, Apple Valley, CA 92307
Phone: 760-242-2311    Fax: 760-946-8875
Stephanie Hansen, CNM
Advanced Practice Midwife
Medicare: Medicare Enrolled
Practice Location: 18056 Wika Rd Ste B, Apple Valley, CA 92307
Phone: 760-813-3699    
Mrs. Kimberly Sue Deimling-meyer, CNM
Advanced Practice Midwife
Medicare: Medicare Enrolled
Practice Location: 18300 Us Highway 18, Apple Valley, CA 92307
Phone: 760-242-2311    Fax: 760-946-8875
Laurie Roberts, CNM
Advanced Practice Midwife
Medicare: Medicare Enrolled
Practice Location: 18077 Us Highway 18, Suite 100, Apple Valley, CA 92307
Phone: 760-946-8799    Fax: 760-946-8875
Dr. Matthew Larsen, DNP, CNM, WHNP-BC
Advanced Practice Midwife
Medicare: Medicare Enrolled
Practice Location: 18077 Outer Hwy 18 Ste 100, Apple Valley, CA 92307
Phone: 760-946-8169    Fax: 760-946-8875

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