Sofia Carmen Bustillo, - Medicare Physician Assistant in Seal Beach, CA

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Sofia Carmen Bustillo, is a medicare enrolled "Physician Assistant - Medical" in Seal Beach, California. She graduated from nursing school in 2020 and has 6 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Providence Saint Johns Medical Foundation and her current practice location is 1709 Coral Pl, Seal Beach, California. You can reach out to her office (for appointments etc.) via phone at (562) 588-5143.

Sofia Carmen Bustillo is licensed to practice in California (license number 58679) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1275144313.

Contact Information

Sofia Carmen Bustillo,
1709 Coral Pl,
Seal Beach, CA 90740-5712
(562) 588-5143
Not Available

Map and Direction




Provider's Profile

Full NameSofia Carmen Bustillo
GenderFemale
SpecialityPhysician Assistant
Experience6 Years
Location1709 Coral Pl, Seal Beach, California
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Sofia Carmen Bustillo graduated from nursing school in 2020
  NPI Data:
  • NPI Number: 1275144313
  • Provider Enumeration Date: 08/12/2020
  • Last Update Date: 07/09/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 7416335559
  • Enrollment ID: I20220602000751

Medical Identifiers

Medical identifiers for Sofia Carmen Bustillo such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1275144313NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant PA58679 (California)Secondary
363AM0700XPhysician Assistant - Medical 58679 (California)Primary
363AM0700XPhysician Assistant - Medical (* (Not Available))Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Saint John's Health CenterSanta monica, CAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Providence Saint Johns Medical Foundation0840548624282

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. Sofia Carmen Bustillo allows following entities to bill medicare on her behalf.
Entity NameCep America - California
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023063542
PECOS PAC ID: 6103739131
Enrollment ID: O20031106000520
Entity NameCep America - California
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1548667843
PECOS PAC ID: 6103739131
Enrollment ID: O20040121000458
Entity NameProvidence Saint Johns Medical Foundation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1770093734
PECOS PAC ID: 0840548624
Enrollment ID: O20180810000904

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. Sofia Carmen Bustillo 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
Sofia Carmen Bustillo,
1709 Coral Pl,
Seal Beach, CA 90740-5712

Ph: (562) 588-5143		Sofia Carmen Bustillo,
1709 Coral Pl,
Seal Beach, CA 90740-5712

Ph: (562) 588-5143

Reviews and Comments


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Stephen E Teipe, PA-C
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Phone: 562-799-7071    Fax: 562-594-5627

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.