MARK DREW PELLEGRINO MD
NPI 1124176912
Family Medicine - Geriatric Medicine in Anaheim, CA

Q: What is Mark Pellegrino's NPI number?

The NPI number for Mark Pellegrino is 1124176912. It was assigned to this individual provider in the NPPES registry on January 8, 2007.

Q: What is Mark Pellegrino's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

Q: When was this NPI record last updated?

The NPPES record for Mark Pellegrino was last updated on November 29, 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.

Active since January 08, 2007PECOS Enrolled

441 N LAKEVIEW AVE, ANAHEIM, CA 92807(888) 988-2800 Get Directions Write a Review

NPPES record last updated: November 29, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Mark Drew Pellegrino Md NPPES

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

MARK DREW PELLEGRINO MD (NPI 1124176912) is an individual geriatric medicine provider in Anaheim, California, licensed in California (G69878) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124176912

Entity TypeIndividualMale

Primary Taxonomy207QG0300X

Provider Legal NameMARK DREW PELLEGRINOCredential: MD

Location Address441 N LAKEVIEW AVEAnaheim, CA 92807-3028

Mailing Address441 N Lakeview AveAnaheim, CA 92807-3028 · (888) 988-2800

Phone(888) 988-2800

Sole ProprietorNo

Enumeration DateJanuary 8, 2007

Last NPPES UpdateNovember 29, 2021

✔ NPI 1124176912 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QG0300X

License✔ Licensed in CA · G69878

Definition

A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

441 N LAKEVIEW AVE, Anaheim, CA 92807

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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)

Mark Drew Pellegrino Md 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 Mark Pellegrino reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group

Same address

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92807 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

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

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.

DINO A. IMPERIAL DO

Family Medicine