DR. STANLEY JAMES SETIAWAN MD
NPI 1063772762
Family Medicine in Fontana, CA
About Dr. Stanley James Setiawan Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. STANLEY JAMES SETIAWAN MD (NPI 1063772762) is an individual family medicine provider in Fontana, California, licensed in California (A119865) and active in the NPI registry since May 2012. He is enrolled in Medicare PECOS and is a graduate of Loma Linda University School Of Medicine (2010).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Stanley James Setiawan Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Stanley Setiawan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fontana, CA 92335
- Reassigned Medicare billing, California enrollment
- 5,228 clinicians in this Medicare group
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 92335 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
FONTANA, CA 92335
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 Stanley Setiawan's NPI number?
The NPI number for Stanley Setiawan is 1063772762. It was assigned to this individual provider in the NPPES registry on May 29, 2012.
Where is Stanley Setiawan located?
Stanley Setiawan practices at 9961 Sierra Ave, Fontana, CA 92335. The listed phone number is (188) 875-0003.
What is Stanley Setiawan's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Stanley Setiawan enrolled in Medicare?
Yes. Stanley Setiawan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Stanley Setiawan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Stanley Setiawan reassigns Medicare benefits to Southern California Permanente Medical Group (Fontana, CA). The 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 Stanley Setiawan'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 Stanley Setiawan was last updated on December 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.
# Dr. Stanley James Setiawan, MD · NPI 1063772762
Family Medicine physician in Fontana, California. Individual provider, active in the CMS NPPES registry since May 29, 2012.
## Identity
- **NPI:** 1063772762 (Entity type: Individual)
- **Enumerated:** May 29, 2012
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** A119865 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 9961 SIERRA AVE, Fontana, CA 92335-6720
- **Phone:** (188) 875-0003
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Southern California Permanente Medical Group (NPI 1689606196, Fontana, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Loma Linda University School Of Medicine, class of 2010
## Record status
- **NPPES last updated:** December 1, 2021
---
Source: [NPI Profile](https://npiprofile.com/npi/1063772762) · Data from the CMS NPPES public registry.