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KATIE VICKLUN
NPI 1962185405
Nurse Practitioner - Family in Long Beach, CA

Active since August 10, 2023PECOS Enrolled
200 OCEANGATE STE 100, LONG BEACH, CA 90802(562) 499-6191 Get Directions Write a Review

NPPES record last updated: September 15, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 15, 2025, Aug 10, 2023 (2 updates tracked since 2023).

About Katie Vicklun NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATIE VICKLUN (NPI 1962185405) is an individual family provider in Long Beach, California, licensed in California (95026753) and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962185405
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKATIE VICKLUN
Location Address200 OCEANGATE STE 100Long Beach, CA 90802-4317
Mailing Address5038 Chaparral WaySan Diego, CA 92115-2238 · (619) 602-7773
Phone(562) 499-6191
Sole ProprietorYes
Enumeration DateAugust 10, 2023
Last NPPES UpdateSeptember 15, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 15, 2025
✔ NPI 1962185405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95026753
200 OCEANGATE STE 100, Long Beach, CA 90802
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Katie Vicklun is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Katie Vicklun reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Molina Healthcare Of California
Same address
Health Maintenance Organization
200 OCEANGATE STE 100
Long Beach, CA 90802
  • Reassigned Medicare billing, California enrollment
  • 339 clinicians in this Medicare group
NPI 1194811760 (562) 499-6191
Central Health Plan Of California, Inc.
26 mi
Health Maintenance Organization
1540 BRIDGEGATE DR
Diamond Bar, CA 91765
  • Reassigned Medicare billing, California enrollment
  • 283 clinicians in this Medicare group
NPI 1386714772 (626) 388-2390

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90802 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MOLINA MEDICAL GROUP OF NEW MEXICO, PC
Family Medicine
200 OCEANGATE STE 100
LONG BEACH, CA 90802
Los Angeles County (562) 499-6191
DARLENA THACH FNP-C
Nurse Practitioner (Family)
200 OCEANGATE STE 100
LONG BEACH, CA 90802
Los Angeles County (888) 562-5442
JOANNA DURON FNP
Nurse Practitioner (Family)
200 OCEANGATE STE 100
LONG BEACH, CA 90802
Los Angeles County (760) 718-5648
JENNIFER M DONALDSON
Nurse Practitioner (Family)
200 OCEANGATE STE 100
LONG BEACH, CA 90802
Los Angeles County (888) 562-5442
MELISSA STEWART LCSW
Social Worker (Clinical)
200 OCEANGATE STE 100
LONG BEACH, CA 90802
Los Angeles County (860) 255-4640
DAISY O ALVARADO FNP-C, RN, PHN, CBN
Nurse Practitioner (Family)
200 OCEANGATE STE 100
LONG BEACH, CA 90802
Los Angeles County (951) 660-6224
MRS. CHARLYNE GABRIEL-JACQUES ARNP
Nurse Practitioner (Psychiatric/Mental Health)
200 OCEANGATE STE 100
LONG BEACH, CA 90802
Los Angeles County (305) 382-4161
ALYSSA AREEPRACHAPIROM
Nurse Practitioner (Psychiatric/Mental Health)
200 OCEANGATE STE 100
LONG BEACH, CA 90802
Los Angeles County (888) 562-5442

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Katie Vicklun's NPI number?

The NPI number for Katie Vicklun is 1962185405. It was assigned to this individual provider in the NPPES registry on August 10, 2023.

Where is Katie Vicklun located?

Katie Vicklun practices at 200 Oceangate Ste 100, Long Beach, CA 90802. The listed phone number is (562) 499-6191.

What is Katie Vicklun's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Katie Vicklun enrolled in Medicare?

Yes. Katie Vicklun is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Katie Vicklun's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Katie Vicklun reassigns Medicare benefits to 2 organizations: Molina Healthcare Of California (Long Beach, CA) and Central Health Plan Of California, Inc. (Diamond Bar, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Katie Vicklun's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Katie Vicklun was last updated on September 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.