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NICHOLAS SYNSTELIEN
NPI 1104407477
Student in an Organized Health Care Education/Training Program in Loma Linda, CA

Active since April 19, 2021PECOS Enrolled
11234 ANDERSON ST, LOMA LINDA, CA 92350(909) 558-4085 Get Directions Write a Review

NPPES record last updated: October 25, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Nicholas Synstelien NPPES

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

NICHOLAS SYNSTELIEN (NPI 1104407477) is an individual student in an organized health care education/training program in Loma Linda, California and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104407477
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameNICHOLAS SYNSTELIEN
Location Address11234 ANDERSON STLoma Linda, CA 92350-1716
Mailing Address11234 Anderson St, Gme Office Westerly Suite CLoma Linda, CA 92350-1716 · (909) 558-4085
Phone(909) 558-4085
Sole ProprietorNo
Enumeration DateApril 19, 2021
Last NPPES UpdateOctober 25, 2024
NPPES CertifiedApril 19, 2021
✔ NPI 1104407477 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
11234 ANDERSON ST, Loma Linda, CA 92350
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicholas Synstelien is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Nicholas Synstelien reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
35 mi
Health Maintenance Organization
441 N LAKEVIEW AVE
Anaheim, CA 92807
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1952333460 (714) 279-4000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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. THUCAN TIMOTHY BUI DO
Emergency Medicine
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-4344
VAHE YACOUBIAN MD, MPH
Orthopaedic Surgery
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (818) 813-4234
AISHA Q EALEY APRN, ACCCNS-N
Clinical Nurse Specialist (Neonatal)
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-4248
MR. RANDAL KEITH GILMAN PA
Physician Assistant
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-4475
AMR AZZAM MD, PHD
Ophthalmology (Retina Specialist)
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-2182
DARSH THAKRAR M.D.
Radiology (Diagnostic Radiology)
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-4000
HAITHAM SIAG MBBCH
Student in an Organized Health Care Education/Training Program
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (914) 267-6104
PRESTON ANDREW SHIRSAT
Student in an Organized Health Care Education/Training Program
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-4074

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 Nicholas Synstelien's NPI number?

The NPI number for Nicholas Synstelien is 1104407477. It was assigned to this individual provider in the NPPES registry on April 19, 2021.

Where is Nicholas Synstelien located?

Nicholas Synstelien practices at 11234 Anderson St, Loma Linda, CA 92350. The listed phone number is (909) 558-4085.

What is Nicholas Synstelien's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Nicholas Synstelien enrolled in Medicare?

Yes. Nicholas Synstelien is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Nicholas Synstelien's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicholas Synstelien reassigns Medicare benefits to Southern California Permanente Medical Group (Anaheim, 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 Nicholas Synstelien'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 Nicholas Synstelien was last updated on October 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.