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MARY VAL DAVID KOHISTANI FNP
NPI 1134093453
Nurse Practitioner - Family in San Diego, CA

Active since September 30, 2025PECOS Enrolled
404 CAMINO DEL RIO S STE 102, SAN DIEGO, CA 92108(800) 316-6314 Get Directions Write a Review

NPPES record last updated: September 30, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mary Val David Kohistani Fnp NPPES

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

MARY VAL DAVID KOHISTANI FNP (NPI 1134093453) is an individual family provider in San Diego, California, licensed in California (95035173) and active in the NPI registry since September 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1134093453
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMARY VAL DAVID KOHISTANICredential: FNP
Location Address404 CAMINO DEL RIO S STE 102San Diego, CA 92108-3586
Mailing AddressPo Box 103Crows Landing, CA 95313-0103
Phone(800) 316-6314
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateSeptember 30, 2025
NPPES CertifiedSeptember 27, 2025
✔ NPI 1134093453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95035173
404 CAMINO DEL RIO S STE 102, San Diego, CA 92108
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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)

Mary Val David Kohistani Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2365908449
PECOS Enrollment IDI20260729001441
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 Mary Val Kohistani reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Golden Valley Health Center
352 mi
Federally Qualified Health Center (FQHC)
1405 CALIFORNIA AVE
Dos Palos, CA 93620
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Golden Valley Health Centers
  • 440 clinicians in this Medicare group
NPI 1770567778 (209) 392-2111

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 92108 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
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
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 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SANDEEP KAUR
Nurse Practitioner (Family)
404 CAMINO DEL RIO S STE 102
SAN DIEGO, CA 92108
San Diego County (800) 316-6314
ANGELINA STEFANICK
Student in an Organized Health Care Education/Training Program
404 CAMINO DEL RIO S STE 102
SAN DIEGO, CA 92108
San Diego County (800) 316-6314
LATOYA MICHAELE ROBERSON FNP-BC
Nurse Practitioner (Family)
404 CAMINO DEL RIO S STE 102
SAN DIEGO, CA 92108
San Diego County (855) 313-0885
KEEZIA YSABEL MARTINEZ ANTAKLI NP
Nurse Practitioner (Family)
404 CAMINO DEL RIO S STE 102
SAN DIEGO, CA 92108
San Diego County (855) 313-0885
JAYAHMIE DRIO TOLENTINO
Nurse Practitioner (Family)
404 CAMINO DEL RIO S STE 102
SAN DIEGO, CA 92108
San Diego County (800) 316-6314
NICOLE ANN CRUZ DUMANGAN FNP-C
Nurse Practitioner (Primary Care)
404 CAMINO DEL RIO S STE 102
SAN DIEGO, CA 92108
San Diego County (800) 316-6314
JENNIFER ERIN FREITAS MSN, APRN, FNP-C
Nurse Practitioner (Family)
404 CAMINO DEL RIO S STE 102
SAN DIEGO, CA 92108
San Diego County (800) 316-6314
RACHEL DELANEY MCCAW
Nurse Practitioner (Family)
404 CAMINO DEL RIO S STE 102
SAN DIEGO, CA 92108
San Diego County (800) 316-6314

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 Mary Val Kohistani's NPI number?

The NPI number for Mary Val Kohistani is 1134093453. It was assigned to this individual provider in the NPPES registry on September 30, 2025.

Where is Mary Val Kohistani located?

Mary Val Kohistani practices at 404 Camino Del Rio S Ste 102, San Diego, CA 92108. The listed phone number is (800) 316-6314.

What is Mary Val Kohistani's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Mary Val Kohistani enrolled in Medicare?

Yes. Mary Val Kohistani is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mary Val Kohistani's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Val Kohistani reassigns Medicare benefits to Golden Valley Health Center (Dos Palos, 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 Mary Val Kohistani'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 Mary Val Kohistani was last updated on September 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.