01 Blue Shield 65 Plus (HMO) Provider Directory/Directorio de Proveedores This directory is current as of August 30, 2019. This directory provides a list of Blue Shield 65 Plus (HMO) current network providers. This directory is for: Central California To access Blue Shield 65 Plus (HMO)'s online provider directory, you can visit blueshieldca.com/find-a-doctor. For any questions about the information contained in this directory (hardcopy or online), please call our Member Services Department at (800) 776-4466, 8 a.m. to 8 p.m., seven days a week, from October 1 through March 31, and 8 a.m. to 8 p.m., weekdays (8 a.m. to 5 p.m., Saturday and Sunday), from April 1 through September 30. TTY users should call 711. Blue Shield of California is an HMO plan with a Medicare contract. Enrollment in Blue Shield depends on contract renewal. The provider network may change at any time. You will receive notice when necessary ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-800-776-4466 (TTY: 711). H0504_18_305A1_M NM 08022018 MR15184-12 (09/19) Este directorio tiene vigencia a partir del August 30, 2019. Este directorio brinda una lista de los proveedores de la red actuales de Blue Shield 65 Plus (HMO) Este directorio es para: Central California Para obtener acceso al directorio de proveedores en línea de Blue Shield 65 Plus (HMO), puede visitar blueshieldca.com/find-a-doctor. Si tiene alguna pregunta sobre la informacióin incluida en este directorio (ya sea la versión impresa o la versión electrónica), comuníquese con nuestro Departamento de Servicio para Miembros llamando al (800) 776-4466, de 8:00 a. m. a 8:00 p. m., cualquier día de la semana, desde el 1 de octubre hasta el 31 de marzo, y de 8:00 a. m. a 8:00 p. m., de lunes a viernes (de 8:00 a. m. a 5:00 p. m. los sábados y domingos), desde el 1 de abril hasta el 30 de septiembre. Los usuarios del sistema TTY deben llamar al 711. Blue Shield of California es un plan HMO que tiene un contrato con Medicare. La inscripción en Blue Shield depende de la renovación del contrato. La red de proveedores puede cambiar en cualquier momento. Recibirá un aviso cuando sea necesario. ATENCIÓN: Si no habla inglés, tiene a su disposición gratis el servicio de asistencia en idiomas. Llame al 1-800-776-4466 (TTY: 711). H0504_18_305A1_M_SP NM 08022018 MR15184-12 (09/19) Table of Contents/Índice de contenidos Section 1 ± Introduction..........................................................................................................V What is the service area for Blue Shield 65 Plus (HMO)? ...........................................V How do you find Blue Shield 65 Plus (HMO) providers in your area? .......................VI Section 2 ± List of Network Providers.....................................................................................VII Sección 1: Introducción.........................................................................................................VIII ¿Cuál es el área de servicio de Blue Shield 65 Plus (HMO)? ....................................IX ¿Cómo puede encontrar proveedores de Blue Shield 65 Plus (HMO) en su área?......................................................................................................................IX Sección 2: Lista de proveedores de la red..........................................................................X Physician Groups/ Grupos médicos Americas Health Plan....................................................................................................1 Community Memorial Hosp Of San Buenaventura Ojai Valley Community Hospital Santa Paula Hospital St Johns Pleasant Valley Hosp St Johns Regional Med Ctr Mercy Hlthcre Ventur Ventura County Med Ctr Bakersfield Family Med Group.....................................................................................10 Bakersfield Memorial Hosp Mercy Hospital Bakersfield Central Valley Medical Providers Inc..........................................................................20 St Agnes Medical Center Coastal Communities Provider Network.....................................................................40 First Choice Medical Group..........................................................................................49 St Agnes Medical Center Gemcare Medical Group Inc Bakersfield Region .....................................................59 Bakersfield Memorial Hosp Mercy Hospital Bakersfield Gemcare Medical Group Inc Delano Region............................................................71 Bakersfield Memorial Hosp Delano Regional Med Ctr Mercy Hospital Bakersfield Health Now IPA ..............................................................................................................76 San Joaquin Comm Hosp Physician Choice Med Grp Of San Luis Obispo .........................................................80 Marian Regional Medical Center Physicians Choice Med Grp Santa Maria...................................................................87 Marian Regional Medical Center Regal Ventura County...................................................................................................92 Santa Paula Hospital St Johns Pleasant Valley Hosp St Johns Regional Med Ctr Mercy Hlthcre Ventur Ventura County Med Ctr Sante Community Phys Inc Sante Health System ......................................................103 Clovis Community Hospital Fresno Community Hospital III Seaview IPA....................................................................................................................146 Community Memorial Hosp Of San Buenaventura Ojai Valley Community Hospital Santa Paula Hospital St Johns Pleasant Valley Hosp St Johns Regional Med Ctr Mercy Hlthcre Ventur Valley Care IPA..............................................................................................................157 Community Memorial Hosp Of San Buenaventura Santa Paula Hospital St Johns Pleasant Valley Hosp St Johns Regional Med Ctr Mercy Hlthcre Ventur Ventura County Med Ctr Mental Health Providers/ Proveedores de servicios de salud mental ....................168 Dentists / Dentistas.........................................................................................................170 Skilled Nursing Facilities/ Centros de enfermería especializada ............................188 Index/ Índice..................................................................................................................190 IV Woodland Hills, CA 91365 needed services while you are Section 1 - outside the plan service area, Introduction If you need care in an we prefer that you return to the emergency, get medical help service area to get follow-up as quickly as possible. Call 911 care through your PCP. This directory provides a list of for help or go to the nearest However, we will cover Blue Shield 65 Plus (HMO) emergency room. You do not follow-up care that you get from network providers. need to get permission first from non-network providers outside your physician or other network the plan service area as long as To get detailed information provider. the care you are getting still about your health care meets the definition of ªurgently coverage, please see your A medical emergency is when needed services.º Evidence of Coverage. you believe that you have medical symptoms that require You must use network providers You will have to choose one of immediate medical attention to except in emergency or urgent our network providers listed in prevent loss of life, loss of a limb, care situations or for out-of-area this directory to be your Primary or loss of function of a limb. The renal dialysis or other services. If Care Physician (PCP). Generally, medical symptoms may be an you obtain routine care from you must get your health care illness, injury, severe pain, or a out-of-network providers, neither services from your PCP. When medical condition that is quickly Medicare nor Blue Shield will be you choose your PCP, you are getting much worse. responsible for the costs. also choosing the hospital(s) and specialty network affiliated Make sure that Blue Shield What is the service area for Blue with the physician group. knows about your emergency Shield 65 Plus (HMO)? because your physician will The network providers listed in need to be involved in following The ªcountyº or ªcountiesº and this directory have agreed to up on your emergency care. parts of counties/zip codes in provide you with your health our service area are listed care and/or dental services. You or someone else should call below. You may go to any of our to tell your physician about your network providers listed in this emergency care as soon as Fresno County (All Zips) directory, however, some possible, preferably within 48 services may require a referral. hours. The number to call is Kern County (Partial) Other providers are available in located on your plan ID card. 93203 93215 93216 93220 93241 our network. 93250 93263 93268 93280 93301 If you need medical help 93302 93303 93304 93305 93306 If you receive a bill from any immediately but your health is 93307 93308 93309 93311 93312 non-network provider for not in serious danger, the help 93313 93314 93380 93383 93384 covered services such as you need is called ªurgently 93385 93386 93387 93388 93389 emergency or urgently needed needed servicesº. If you are in 93390 93561 93581 services or out-of-area renal your plan's service area please dialysis services, please do not call your PCP or, if