DR. MARIO FERNANDO SAN BARTOLOME JR. MD
NPI 1154420024
Preventive Medicine - Addiction Medicine in Westminster, CA

Active since September 21, 2006PECOS EnrolledAccepts Medicare Assignment
5405 GARDEN GROVE BLVD STE 102, WESTMINSTER, CA 92683(714) 598-3707(714) 422-0260 Get Directions Write a Review

NPPES record last updated: August 8, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 8, 2019, Jan 29, 2019, Oct 21, 2016 and 4 more (7 updates tracked since 2015).

About Dr. Mario Fernando San Bartolome Jr. Md NPPES

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

DR. MARIO FERNANDO SAN BARTOLOME JR. MD (NPI 1154420024) is an individual addiction medicine provider in Westminster, California, licensed in California (A89818) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS and is a graduate of University Of California, Irvine, California College Of Medicine (2003).

NPPES Registry Identity

NPI1154420024
Entity TypeIndividualMale
Primary Taxonomy2083A0300X
Provider Legal NameDR. MARIO FERNANDO SAN BARTOLOME JR.Credential: MD
Location Address5405 GARDEN GROVE BLVD STE 102Westminster, CA 92683-1887
Mailing Address5405 Garden Grove Blvd Ste 102Westminster, CA 92683-1887 · (714) 598-3707 · Fax (714) 422-0260
Fax(714) 422-0260
Sole ProprietorNo
Medical School CMSUniversity Of California, Irvine, California College Of MedicineGraduated 2003
Enumeration DateSeptember 21, 2006
Last NPPES UpdateAugust 8, 20197 updates tracked since enumeration
NPI 1154420024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyPreventive Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2083A0300X
License Licensed in CA · A89818
Definition

A physician engaged in the subspecialty practice of Addiction Medicine who specializes in the prevention, evaluation, diagnosis, treatment, and recovery of persons with the disease of addiction.

Also ListedSpecialistTaxonomy 174400000X · License A89818 (CA)
Also ListedFamily Medicine · Adolescent MedicineTaxonomy 207QA0000X · License A89818 (CA)
Also ListedFamily Medicine · Adult MedicineTaxonomy 207QA0505X · License A89818 (CA)
5405 GARDEN GROVE BLVD STE 102, Westminster, CA 92683

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Mario Fernando San Bartolome Jr. Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9032273503
PECOS Enrollment IDI20090128000104
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92683 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
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
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.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1154420024, enumerated as an "individual" on September 21, 2006.

The provider is located at 5405 GARDEN GROVE BLVD STE 102 WESTMINSTER, CA 92683 and the phone number is (714) 598-3707.

Preventive Medicine with taxonomy code 2083A0300X and a focus in Addiction Medicine.