Dr Mario Fernando San Bartolome Jr, MD is a medicare enrolled "Preventive Medicine - Addiction Medicine" physician in Westminster, California. He went to University Of California, Irvine, California College Of Medicine and graduated in 2003 and has 21 years of diverse experience with area of expertise as Addiction Medicine. He is a member of the group practice Korean Community Services Inc and his current practice location is
5405 Garden Grove Blvd Ste 102, Westminster, California. You can reach out to his office (for appointments etc.) via phone at
(714) 598-3707.
Dr Mario Fernando San Bartolome Jr is licensed to practice in California (license number A89818) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1154420024.
Physician's Profile
| Full Name | Dr Mario Fernando San Bartolome Jr |
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| Gender | Male |
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| Speciality | Addiction Medicine |
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| Experience | 21 Years |
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| Location | 5405 Garden Grove Blvd Ste 102, Westminster, California |
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| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Mario Fernando San Bartolome Jr attended and graduated from University Of California, Irvine, California College Of Medicine in 2003
NPI Data:
- NPI Number: 1154420024
- Provider Enumeration Date: 09/21/2006
- Last Update Date: 08/08/2019
Medicare PECOS Information:
- PECOS PAC ID: 9032273503
- Enrollment ID: I20090128000104
Medical Identifiers
Medical identifiers for Dr Mario Fernando San Bartolome Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1154420024 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207QA0000X | Family Medicine - Adolescent Medicine | A89818 (California) | Secondary |
| 207QA0505X | Family Medicine - Adult Medicine | A89818 (California) | Secondary |
| 174400000X | Specialist | A89818 (California) | Secondary |
| 2083A0300X | Preventive Medicine - Addiction Medicine | A89818 (California) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Korean Community Services Inc | 0446495105 | 9 |
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. Dr Mario Fernando San Bartolome Jr allows following entities to bill medicare on his behalf.
| Entity Name | Korean Community Services Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1861525602
PECOS PAC ID: 0446495105
Enrollment ID: O20211118000437 |
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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. Dr Mario Fernando San Bartolome Jr 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 Address | Practice Location Address |
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Dr Mario Fernando San Bartolome Jr, MD
5405 Garden Grove Blvd Ste 102,
Westminster, CA 92683-1887
Ph: (714) 598-3707 | Dr Mario Fernando San Bartolome Jr, MD
5405 Garden Grove Blvd Ste 102,
Westminster, CA 92683-1887
Ph: (714) 598-3707 |
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