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KRISTOFER JOHN VANCE MD
NPI 1124643135
Pediatrics in Loma Linda, CA

Active since June 15, 2020PECOS Enrolled
11234 ANDERSON ST, LOMA LINDA, CA 92354(909) 558-4174 Get Directions Write a Review

NPPES record last updated: July 17, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 17, 2023, Jun 15, 2020 (2 updates tracked since 2020).

About Kristofer John Vance Md NPPES

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

KRISTOFER JOHN VANCE MD (NPI 1124643135) is an individual pediatrics provider in Loma Linda, California, licensed in California (A187521) and active in the NPI registry since June 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124643135
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameKRISTOFER JOHN VANCECredential: MD
Location Address11234 ANDERSON STLoma Linda, CA 92354-2804
Mailing Address11234 Anderson St, Gme Office Westerly Suite CLoma Linda, CA 92354-2804 · (909) 558-4174
Phone(909) 558-4174
Sole ProprietorNo
Enumeration DateJune 15, 2020
Last NPPES UpdateJuly 17, 20232 updates tracked since enumeration
NPPES CertifiedJuly 17, 2023
✔ NPI 1124643135 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A187521
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
11234 ANDERSON ST, Loma Linda, CA 92354
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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)

Kristofer John Vance 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 Kristofer Vance reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Faculty Physicians And Surgeons Of Llusm
Same address
Anatomic Pathology & Clinical Pathology
11234 ANDERSON ST
Loma Linda, CA 92354
  • Reassigned Medicare billing, California enrollment
  • 2,584 clinicians in this Medicare group
NPI 1245605781 (909) 558-6122

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 92354 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
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
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.

ELYSE LAUREN GURAN
Anesthesiology
11234 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-4015
SAMUEL COOK CHAMBI
Anesthesiology
11234 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-4015
LUIS MIGUEL OLMEDO TEMICH MD
General Practice
11234 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2822
HYUKJE SUNG MD, MA
Preventive Medicine (Occupational Medicine)
11234 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-6491
JEFFERSON BRANCH RICHARDS
Student in an Organized Health Care Education/Training Program
11234 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-4074
JOSEPH UNIS M.D.
Radiology (Diagnostic Radiology)
11234 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-8311
MARINA LIU M.D.
Anesthesiology
11234 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-4475
JOSEPH M WILKINSON CRNA
Nurse Anesthetist, Certified Registered
11234 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-4475

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 Kristofer Vance's NPI number?

The NPI number for Kristofer Vance is 1124643135. It was assigned to this individual provider in the NPPES registry on June 15, 2020.

Where is Kristofer Vance located?

Kristofer Vance practices at 11234 Anderson St, Loma Linda, CA 92354. The listed phone number is (909) 558-4174.

What is Kristofer Vance's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Kristofer Vance enrolled in Medicare?

Yes. Kristofer Vance is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kristofer Vance's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kristofer Vance reassigns Medicare benefits to Faculty Physicians And Surgeons Of Llusm (Loma Linda, 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 Kristofer Vance'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 Kristofer Vance was last updated on July 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.