2020 2020 Provider Directory Provider Directory Brand New Day Harmony Choice Plan (HMO CSNP) 20 Brand New Day Harmony Choice Plan (HMO CSNP) 20 Brand New Day Dual Access Plan (HMO DSNP) 24 Brand New Day Dual Access Plan (HMO DSNP) 24 Brand New Day Bridges Care Plan (HMO CSNP) 28 Brand New Day Bridges Care Plan (HMO CSNP) 28 Brand New Day Bridges Choice Plan (HMO CSNP) 29 Brand New Day Bridges Choice Plan (HMO CSNP) 29 Brand New Day Harmony Care Plan (HMO CSNP) 32 Brand New Day Harmony Care Plan (HMO CSNP) 32 Brand New Day Classic Choice Plan (HMO) 33 Brand New Day Classic Choice Plan (HMO) 33 Brand New Day Classic Care II Plan (HMO) 37 Brand New Day Classic Care II Plan (HMO) 37 Brand New Day Embrace Care Plan (HMO CSNP) 39-1 & Brand New Day Embrace Care Plan (HMO CSNP) 39-1 & 39-2 39-2 Brand New Day Embrace Choice Plan (HMO CSNP) 40-1 Brand New Day Embrace Choice Plan (HMO CSNP) 40-1 & 40-2 & 40-2 Brand New Day Select Care Plan (HMO ISNP) 41 Brand New Day Select Care Plan (HMO ISNP) 41 This directory is current as of October 15,2019. This directory provides a list of Brand New Day’s current network providers. This directory is for Imperial County. To access Brand New Day’s online provider directory, you can visit www.bndhmo.com . For any questions about the information contained in this directory (hardcopy or online), please call our Member Service Department at 866-255-4795, Monday through Friday from 8:00 a.m. to 8:00 p.m. and weekends from 8:00 a.m. to 8:00 p.m. (between October 1st and March 31st). TTY/TDD users should call 866-321-5955. Brand New Day is a HMO with Medicare contract. Enrollment in Brand New Day depends on contract renewal. The provider network may change at any time. You will receive notice when necessary. ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-866-255-4795 (TTY: 711). ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-255-4795 (TTY: 711). 1
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20202020Provider DirectoryProvider Directory
Brand New Day Harmony Choice Plan (HMO CSNP) 20Brand New Day Harmony Choice Plan (HMO CSNP) 20Brand New Day Dual Access Plan (HMO DSNP) 24Brand New Day Dual Access Plan (HMO DSNP) 24Brand New Day Bridges Care Plan (HMO CSNP) 28Brand New Day Bridges Care Plan (HMO CSNP) 28
Brand New Day Bridges Choice Plan (HMO CSNP) 29Brand New Day Bridges Choice Plan (HMO CSNP) 29Brand New Day Harmony Care Plan (HMO CSNP) 32Brand New Day Harmony Care Plan (HMO CSNP) 32
Brand New Day Classic Choice Plan (HMO) 33Brand New Day Classic Choice Plan (HMO) 33Brand New Day Classic Care I I Plan (HMO) 37Brand New Day Classic Care I I Plan (HMO) 37
Brand New Day Embrace Care Plan (HMO CSNP) 39-1 &Brand New Day Embrace Care Plan (HMO CSNP) 39-1 &39-239-2
Brand New Day Embrace Choice Plan (HMO CSNP) 40-1Brand New Day Embrace Choice Plan (HMO CSNP) 40-1& 40-2& 40-2
Brand New Day Select Care Plan (HMO ISNP) 41Brand New Day Select Care Plan (HMO ISNP) 41
This directory is current as of October 15,2019.
This directory provides a list of Brand New Day’s current network providers.
This directory is for Imperial County.
To access Brand New Day’s online provider directory, you can visit www.bndhmo.com .For any questions about the information contained in this directory (hardcopy or online),please call our Member Service Department at 866-255-4795, Monday through Fridayfrom 8:00 a.m. to 8:00 p.m. and weekends from 8:00 a.m. to 8:00 p.m. (between October1st and March 31st). TTY/TDD users should call 866-321-5955. Brand New Day is a HMOwith Medicare contract. Enrollment in Brand New Day depends on contract renewal. Theprovider network may change at any time. You will receive notice when necessary.ATTENTION: If you speak English, language assistance services, free of charge, areavailable to you. Call 1-866-255-4795 (TTY: 711). ATENCIÓN: si habla español, tiene a sudisposición servicios gratuitos de asistencia lingüística. Llame al 1-866-255-4795 (TTY:711).
Sect ion 1 – Int roduct ionSect ion 1 – Int roduct ion 3
What is the service area for Brand New Day ? 4
How do you find Brand New Day providers in your area? 4
Sect ion 2 – List of Network ProvidersSect ion 2 – List of Network Providers 5
Vision, Dental and Ancillary Providers 5
Primary Care Physicians Affiliated with IPAs 7
Specialists Affiliated with IPAs 11
Primary Care Physicians Affiliated Directly with Brand New Day 19
Hospitals 20
Urgent Care 21
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Sect ion 1 – Int roduct ionSect ion 1 – Int roduct ion
This directory provides a list of Brand New Day network providers. To get detailedinformation about your health care coverage, please see your Evidence of Coverage(EOC).
Use this directory to find Brand New Day network providers for your care needs. Networkproviders are the doctors and other health care professionals, medical groups, hospitals,and other health care facilities that have an agreement with us to accept our paymentand any plan cost sharing as payment in full. We have arranged for these providers todeliver covered services to members in our plan.
It is important to know which providers are with our network because, with limitedexceptions, while you are a member of our plan you must use network providers toobtain your medical care and services. The only exceptions are emergencies, urgentlyneeded care when the network is not available (generally when you are out of the area),out-of-area dialysis services, and cases in which Brand New Day authorizes use of out-of-network providers.
You will have to choose one of our network providers listed in this directory to be yourPrimary Care Provider (PCP). Generally, you must get your health care services from yourPCP. Your PCP is a physician who meets State requirements and is trained to give youbasic medical care. Your PCP will provide most of your care and will help arrange orcoordinate the rest of the covered services you get as a member of our Plan. Thisincludes: x-rays, laboratory tests, therapy, care from doctors who are specialists, hospitaladmissions, and follow up care.
The “network providers” listed in this directory have agreed to provide you with yourHealth care and vision coverage. You may go to any of our network providers listed in thisdirectory; however, some services may require a referral and prior authorization fromBrand New Day.
If you have been going to one network provider, you are not required to continue to goto that same provider. Other physicians/providers are available in our network. In somecases, you may get covered services from non-network providers.
The “network providers” listed in this directory have agreed to provide you with yourmedical health care, vision and dental services. You may go to any of our networkproviders listed in this directory; however, some services require a referral and priorauthorization from Brand New Day.
If you have been going to one network provider, you are not required to continue to goto that same provider. Other physicians/providers are available in our network. In somecases, you may get covered services from non-network providers.
Med ical groups and Independent Pract ice Associat ionsMed ical groups and Independent Pract ice Associat ions
Brand New Day’s Network includes providers associated with Independent PracticeAssociations (IPAs) and Medical Groups. An IPA is a group of physicians under contract toprovide services to members. If you select a doctor that belongs to an IPA or medicalgroup as your PCP, you may be required to only use doctors that belong to that IPA orMedical Group for care. Additionally, you may need to obtain prior authorization for carefrom the IPA or medical group instead of from Brand New Day.
You must use network providers except in emergency or urgent care situations. If youobtain routine care from out-of-network providers, neither Medicare nor Brand New Daywill be responsible for the costs.
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If you receive a bill from an out-of-network provider that gave you emergent or urgentcare (or out of area renal dialysis, do not pay the bill. Submit the bill to Brand New Dayfor review.
Mai l b i l l s f or Prescr ip t ion d rugs t o:Mai l b i l l s f or Prescr ip t ion d rugs t o:Brand New Day c/o Med Impact Claims Depart mentBrand New Day c/o Med Impact Claims Depart ment10181 Scr ipps Gat eway Court10181 Scr ipps Gat eway CourtSan Diego, CA 92131San Diego, CA 92131
Mai l b i l l s f or med ical care t o:Mai l b i l l s f or med ical care t o:Brand New Day Brand New Day P.O. Box 794 P.O. Box 794 Park Ridge, I l l inois 60068Park Ridge, I l l inois 60068
What i s t he service area f or Brand New Day ?What i s t he service area f or Brand New Day ?
The counties in our service area are listed below.Fresno, Imperial, Kings, Kern, Los Angeles, Orange, San Bernardino, Riverside, San Diego,San Mateo, Santa Clara, and Tulare Counties.
How do you f ind Brand New Day p roviders in your area?How do you f ind Brand New Day p roviders in your area?
You may look for a provider using this directory in several ways. To find a provider in yourarea, look for the county or area first. Then search the list of providers for that area. If youknow the name of the provider you are looking for, use our alphabetical index located inthe back of this directory. Our providers are listed according to their associated MedicalGroup or IPA.
Our directory includes Brand New Day contracted specialists, hospitals, urgent care, andskilled nursing facilities. In addition, the directory includes contracted dental providers(We are contracted with Delta Dental USA and Western Dental to use their network ofdentists) and vision providers (We are contracted with MES Vision Care to use theirnetwork of vision care providers).
If you have questions about Brand New Day or require assistance in selecting a PCP,please call our Member Service Department at 1-866-255-4795, Monday through Friday8:00 am to 8:00 pm and weekends from 8:00 am to 8:00 pm (between October 1st andMarch 31st). TTY/TDD users should call 711. Or, visit http://www.bndhmo.com.
For Hear ing impair ed T T Y user s: 711For Hear ing impair ed T T Y user s: 711
T RANSPORAT IONT RANSPORAT ION
SCHEDULE ROUT INE T RANSPORT AT ION (T O AND FROM DOCT OR)SCHEDULE ROUT INE T RANSPORT AT ION (T O AND FROM DOCT OR)Monday-Friday 8:00am-6:00pmPhone: 855-804-3340
SCHEDULE MEDICAL T RANSPORT AT ION (NON-URGENT )SCHEDULE MEDICAL T RANSPORT AT ION (NON-URGENT )Monday-Friday 8:00am-6:00pmPhone: 855-804-3484
REQUEST A BUS PASSREQUEST A BUS PASSMonday-Friday 8:00am-6:00pmPhone: 855-804-3661
For Hear ing impair ed T T Y user s: 711For Hear ing impair ed T T Y user s: 711
VISIONVISION
PROVIDER: MES VISIONPROVIDER: MES VISIONPhone: 833-240-7289Website: www.mesvision.com/bndhmo
For Hear ing impair ed T T Y user s: 877-835-2929For Hear ing impair ed T T Y user s: 877-835-2929
CHIROPRACT OR AND ACCUPUNCT URECHIROPRACT OR AND ACCUPUNCT URE
PROVIDER: AMERICAN SPECIALT Y HEALT H (ASH)PROVIDER: AMERICAN SPECIALT Y HEALT H (ASH)Phone: 800-678-9133Website: www.ashlink.com/ASH/brandnewday
For Hear ing impair ed T T Y user s: 800-735-2922For Hear ing impair ed T T Y user s: 800-735-2922
Pr imary Care Physic ians Af f i l ia ted with IPAsPr imary Care Physic ians Af f i l ia ted with IPAs
Br awl eyBr awl ey
FAMILYFAMILYPRACT ICEPRACT ICE
FAREED, GEORGEFAREED, GEORGEC MDC MDCommunity Care IPA(MH89)Provider # GEFA7751 W LEGION RD,#105Brawley, CA 92227760-344-8750760-344-8750
FR IEDL INE, J OHNFRIEDLINE, J OHNMDMDPremier Patient CareIPA (M174)Provider # JOFR3125 S 5TH ST, #BBrawley, CA 92227760-344-8100760-344-8100
SUAREZ , LORENZ OSUAREZ , LORENZ OH MDH MDImperial CountyPhysicians MedicalGroup (M148)Premier Patient CareIPA (M174)Provider # LOSU125 S 5TH ST,Brawley, CA 92227760-344-8100760-344-8100
T AN, YONG MDT AN, YONG MDImperial CountyPhysicians MedicalGroup (M148)Premier Patient CareIPA (M174)Provider # YOTA751 W LEGION RD,#102Brawley, CA 92227760-351-8696760-351-8696
FED QUALFED QUALHEALT H CT RHEALT H CT R
CLIN ICAS DECLIN ICAS DESALUD, DELSALUD, DELPUEBLOPUEBLOCommunity Care IPA(MH89)Provider # CLDE2900 MAIN ST,Brawley, CA 92227760-344-6471760-344-6471
CLIN ICAS DECLIN ICAS DESALUD, DELSALUD, DELPUEBLOPUEBLOCommunity Care IPA(MH89)Provider # CLDE3283 MAIN ST STE 102,Brawley, CA 92227760-344-9951760-344-9951
GENERALGENERALPRACT ICEPRACT ICE
FAREED, GEORGEFAREED, GEORGEC MDC MDCommunity Care IPA(MH89)Provider # GEFA7751 W LEGION RD,#105Brawley, CA 92227760-344-8750760-344-8750
ST RAUSS, MURRAYST RAUSS, MURRAYR MDR MDCommunity Care IPA(MH89)Provider # MUST900 MAIN ST,Brawley, CA 92227760-344-6471760-344-6471
INT ERNALINT ERNALMEDICINEMEDICINE
DUONG, MAN CDUONG, MAN CMDMDImperial CountyPhysicians MedicalGroup (M148)Provider # MADU334231 US HWAY, 86 #ABrawley, CA 92227760-550-6334760-550-6334
DUONG, MAN CDUONG, MAN CMDMDCommunity Care IPA(MH89)Provider # MADU34900 MAIN ST,Brawley, CA 92227760-344-6471760-344-6471
GHULAM,GHULAM,MEHBOOB DOMEHBOOB DOEasy Access Care IPA(M181)Imperial CountyPhysicians MedicalGroup (M148)Provider # MEGH9207 W LEGION RD,Brawley, CA 92227760-550-6654760-550-6654
OPREA, LUCIANOPREA, LUCIANMDMDPremier Patient CareIPA (M174)Provider # LUOP608 G ST, #1ABrawley, CA 92227760-351-1011760-351-1011
Cal exic oCal exic o
FAMILYFAMILYPRACT ICEPRACT ICE
AZ INGE, WEL IMAZ INGE, WEL IMMDMDCommunity Care IPA(MH89)Provider # WEAZ2420 HEFFERNAN AVE,#DCalexico, CA 92231760-270-9126760-270-9126
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Pr imary Care Physic ians Af f i l ia ted with IPAsPr imary Care Physic ians Af f i l ia ted with IPAs
CEJ A, MARIO L MDCEJ A, MARIO L MDImperial CountyPhysicians MedicalGroup (M148)Premier Patient CareIPA (M174)Provider # MACE9251 W COLE BLVD,Calexico, CA 92231760-357-3768760-357-3768
EST RADA, J AIME EEST RADA, J AIME EMDMDImperial CountyPhysicians MedicalGroup (M148)Premier Patient CareIPA (M174)Provider # JAES1001 E US HIGHWAY98,Calexico, CA 92231760-890-5593760-890-5593
ST RONG, J OHNST RONG, J OHNMDMDEasy Access Care IPA(M181)Provider # JOST111590 S IMPERIAL AVE,El Centro, CA 92243760-352-2551760-352-2551
VO, T IEN T MDVO, T IEN T MDEasy Access Care IPA(M181)Provider # TIVO1590 IMPERIAL AVE,El Centro, CA 92243760-352-2551760-352-2551
FED QUALFED QUALHEALT H CT RHEALT H CT R
8
Pr imary Care Physic ians Af f i l ia ted with IPAsPr imary Care Physic ians Af f i l ia ted with IPAs
CLIN ICAS DECLIN ICAS DESALUD, DELSALUD, DELPUEBLOPUEBLOCommunity Care IPA(MH89)Provider # CLDE6852 E DANENBERGDR,El Centro, CA 92243760-352-2257760-352-2257
GENERALGENERALPRACT ICEPRACT ICE
WICHSER, J AMESWICHSER, J AMESMDMDCommunity Care IPA(MH89)Provider # JAWI34852 E DANENBERGDR,El Centro, CA 92243760-352-2257760-352-2257
INT ERNALINT ERNALMEDICINEMEDICINE
AZ INGE, WEL IMAZ INGE, WEL IMMDMDImperial CountyPhysicians MedicalGroup (M148)Provider # MEAZ52026 N IMPERIAL AVE,#DEl Centro, CA 92243760-693-5372760-693-5372
EL RAMAH,EL RAMAH,MOHSEN MDMOHSEN MDImperial CountyPhysicians MedicalGroup (M148)Premier Patient CareIPA (M174)Provider # MOEL11550 N IMPERIAL AVE,#1El Centro, CA 92243760-352-1731760-352-1731
GUERRERO,GUERRERO,EFRAIN A. NPEFRAIN A. NPCommunity Care IPA(MH89)Provider # EFGU1590 S IMPERIL AVE,El Centro, CA 92243760-353-5933760-353-5933
MALHOT RA,MALHOT RA,RAKESH MDRAKESH MDPremier Patient CareIPA (M174)Provider # RAMA401550 N IMPERIAL AVE,#1El Centro, CA 92243760-352-1731760-352-1731
RE ISIN , SOL MDREISIN , SOL MDImperial CountyPhysicians MedicalGroup (M148)Premier Patient CareIPA (M174)Provider # SORE1550 N IMPERIAL AVE,#1El Centro, CA 92243760-353-4710760-353-4710
SINGH,SINGH,PRABHDEEP MDPRABHDEEP MDImperial CountyPhysicians MedicalGroup (M148)Premier Patient CareIPA (M174)Provider # PRSI92061 ROSS AVE, #BEl Centro, CA 92243760-352-5800760-352-5800
Z ADEH, AL IDAD MZ ADEH, AL IDAD MDODOImperial CountyPhysicians MedicalGroup (M148)Premier Patient CareIPA (M174)Provider # ALZA1600 S IMPERIAL AVE,#3El Centro, CA 92243760-339-2802760-339-2802
Hol t vi l l eHo l t vi l l e
FAMILYFAMILYPRACT ICEPRACT ICE
SOUN, VINCENTSOUN, VINCENTMDMDEasy Access Care IPA(M181)Imperial CountyPhysicians MedicalGroup (M148)Provider # VISO06529 PINE AVE,Holtville, CA 92250760-791-4955760-791-4955
Imper ia lImper ia l
FAMILYFAMILYPRACT ICEPRACT ICE
9
Pr imary Care Physic ians Af f i l ia ted with IPAsPr imary Care Physic ians Af f i l ia ted with IPAs
Z ADEH, HAMID MDZ ADEH, HAMID MDImperial CountyPhysicians MedicalGroup (M148)Provider # HAZA342435 MARSHALL AVE,Imperial, CA 92251760-550-6327760-550-6327
Nil andNil and
FED QUALFED QUALHEALT H CT RHEALT H CT R
CLIN ICAS DECLIN ICAS DESALUD, DELSALUD, DELPUEBLOPUEBLOCommunity Care IPA(MH89)Provider # CLDE78027 HIGHWAY 111,Niland, CA 92257760-359-0110760-359-0110
Wint er havenWint er haven
FED QUALFED QUALHEALT H CT RHEALT H CT R
CLIN ICAS DECLIN ICAS DESALUD, DELSALUD, DELPUEBLOPUEBLOCommunity Care IPA(MH89)Provider # CLDE82133 WINTERHAVENDR,Winterhaven, CA 92283760-572-2700760-572-2700
Pr imary Care Physic ians Af f i l ia ted Direct ly with Brand New DayPr imary Care Physic ians Af f i l ia ted Direct ly with Brand New Day
E l Cent r oE l Cent r o
INT ERNALINT ERNALMEDICINEMEDICINE
EL RAMAH,EL RAMAH,MOHSEN MDMOHSEN MDAllied Health SolutionMedical Group (MH15)American HealthServices (MH05)Brand New DayBrookhurst (MH01)Brand New Day LongBeach Affiliates (MH03)Brand New Day LosAngeles Affiliates(MH18)Inland PsychiatricMedical Group Hemet(MH07)Inland PsychiatricMedical Group MorenoValley (MH09)Inland PsychiatricMedical GroupRedlands (MH02)Joey SantosMD (MH17)Kern Psychiatric andWellness Center(MH04)Memorial CounselingAssociates (MH06)Orange PsychiatricMedical Group (MH08)Orange PsychiatricMedical GroupMurrieta/Temecula(MH16)Provider # MOEL11550 N IMPERIAL AVE,#1El Centro, CA 92243760-352-1731760-352-1731
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HOSPITALSHOSPITALSBr awl eyBr awl ey
Pioneer s Memor ia lPioneer s Memor ia lHeal t hCar e D ist r ic tHeal t hCar e D ist r ic tProvider # PIME207 W Legion Road,Brawley, CA 92227(760) 351-3333(760) 351-3333
E l Cent r oE l Cent r o
E l Cent r o Reg ionalE l Cent r o Reg ionalMed ic al Cent erMed ic al Cent erProvider # ELCE1415 Ross Avenue,El Centro, CA 92243(760) 339-7300(760) 339-7300
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URGENTURGENTCARECARECal exic oCal exic o
CALEXICO HEALT HCALEXICO HEALT HCT RCT RProvider # CAHC450 E BIRCH ST,Calexico, CA 92231760-768-6262760-768-6262
DEANZ A CL IN ICDEANZ A CL IN ICProvider # DECL0910001 BLAIR AVE,Calexico, CA 92231760-768-5055760-768-5055
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NOTICE OF NON-DISCRIMINATIONNOTICE OF NON-DISCRIMINATION
Brand New Day complies with applicable Federal civil rights laws and does notdiscriminate on the basis of race, color, national origin, age, disability, or sex. Brand NewDay does not exclude people or treat them differently because of race, color, nationalorigin, age, disability, or sex.
Brand New Day:
Provides free aids and services to people with disabilities to communicate effectivelywith us, such as:
Qualified sign language interpretersWritten information in other formats (large print, audio, accessible electronicformats, other formats)
Provides free language services to people whose primary language is not English,such as:
Qualified interpretersInformation written in other languages
If you need these services, contact the Brand New Day, Customer Service Department at:1-866-255-4795 (TTY 711). Hours are: October 1 – March 31: 7 days a week, 8 am – 8 pm,April 1 – September 30: Monday – Friday, 8 am – 8 pm.
If you believe that Brand New Day has failed to provide these services or discriminated inanother way on the basis of race, color, national origin, age, disability, or sex, you can filea grievance by calling our Customer Service Department or mailing a letter to:
You can file a grievance in person or by mail, fax, or email. If you need help filing agrievance, our Customer Service Department is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and HumanServices, Office for Civil Rights, electronically through the Office for Civil RightsComplaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail orphone at:
U.S. Department of Health and
Human Services 200
Independence Avenue, SW,
Room 509F, HHH,
Building Washington,
D.C. 20201
1-800-368-1019, 1-800-537-7697(TDD)
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Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html