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INGMAR NIELS BASTIAN STUDENT
NPI 1073263992
Obstetrics & Gynecology in San Diego, CA

Active since March 24, 2022PECOS Enrolled
200 W ARBOR DR, SAN DIEGO, CA 92103(800) 926-8273(888) 539-8781 Get Directions Write a Review

NPPES record last updated: May 5, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Ingmar Niels Bastian Student NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INGMAR NIELS BASTIAN STUDENT (NPI 1073263992) is an individual obstetrics & gynecology provider in San Diego, California, licensed in California (208879) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS, maintains 6 additional practice locations, and is a graduate of University Of Wisconsin School Of Medicine (2022).

NPPES Registry Identity

NPI1073263992
Entity TypeIndividualMale
Primary Taxonomy207V00000X
Provider Legal NameINGMAR NIELS BASTIANCredential: STUDENT
Location Address200 W ARBOR DRSan Diego, CA 92103-9000
Mailing AddressFile 57326Los Angeles, CA 90074-7326 · (800) 926-8273
Phone(800) 926-8273
Fax(888) 539-8781
Sole ProprietorNo
Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 2022
Enumeration DateMarch 24, 2022
Last NPPES UpdateMay 5, 2026
NPPES CertifiedMay 5, 2026
✔ NPI 1073263992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Licenses✔ Licensed in CA · 208879✔ Licensed in WI · STUDENT
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
200 W ARBOR DR, San Diego, CA 92103
Open in Google Maps ↗

Secondary Practice Locations 6

Location 11 Baylor PlzHouston, TX 77030-3411 · Phone (832) 826-7354
Location 24910 Directors Pl Ste 200San Diego, CA 92121-3814 · Phone (800) 926-8273 · Fax (888) 539-8781
Location 316950 Via TazonSan Diego, CA 92127-1607 · Phone (800) 926-8273 · Fax (888) 539-8781
Location 44168 Front StSan Diego, CA 92103-2030 · Phone (800) 926-8273 · Fax (888) 539-8781
Location 5781 Garden View Ct Ste 200Encinitas, CA 92024-2481 · Phone (800) 926-8273 · Fax (888) 539-8781
Location 69300 Campus Point DrLA Jolla, CA 92037-1300 · Phone (800) 926-8273 · Fax (888) 539-8781

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ingmar Niels Bastian Student is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7719456771
PECOS Enrollment IDI20260519003318
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Ingmar Bastian reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Regents Of The University Of California
Same address
Obstetrics & Gynecology
200 W ARBOR DR
San Diego, CA 92103
  • Reassigned Medicare billing, California enrollment
  • 171 clinicians in this Medicare group
NPI 1174626618 (800) 926-8273

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 92103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$140.22 typical visit price
range $62.10 – $184.71
Typical copayment $35.05 (range $15.52 – $46.17)
Most-billed visit code 99204
Established Patient
$76.87 typical visit price
range $20.62 – $151.42
Typical copayment $19.21 (range $5.15 – $37.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. RAMIN MOTARJEMI M.D.
Internal Medicine (Geriatric Medicine)
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (858) 249-2500
DR. KYLE PALMER EDMONDS M.D., FAAHPM
Hospice, Inpatient
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
SHAWN RAVEENTH VEDAMANI MD
Anesthesiology
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
DALE MICHAEL TRUJILLO NP
Nurse Practitioner
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
DR. EUGENE THOMAS RICHARDSON IV MD
Internal Medicine (Infectious Disease)
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
KAYLEE PETERSEN ARNP
Nurse Practitioner (Psychiatric/Mental Health)
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
IRENE NEVAREZ NP
Nurse Practitioner
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
WILLIAM JAMES MOSS M.D.
Student in an Organized Health Care Education/Training Program
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (508) 395-4189

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 Ingmar Bastian's NPI number?

The NPI number for Ingmar Bastian is 1073263992. It was assigned to this individual provider in the NPPES registry on March 24, 2022.

Where is Ingmar Bastian located?

Ingmar Bastian practices at 200 W Arbor Dr, San Diego, CA 92103. The listed phone number is (800) 926-8273.

What is Ingmar Bastian's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Ingmar Bastian enrolled in Medicare?

Yes. Ingmar Bastian is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ingmar Bastian's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ingmar Bastian reassigns Medicare benefits to Regents Of The University Of California (San Diego, 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 Ingmar Bastian'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 Ingmar Bastian was last updated on May 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.