JESSIE LYN BARTOLOME RORALDO
NPI 1174725162
Internal Medicine in Los Angeles, CA
About Jessie Lyn Bartolome Roraldo NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JESSIE LYN BARTOLOME RORALDO (NPI 1174725162) is an individual internal medicine provider in Los Angeles, California, licensed in California (A102737) and active in the NPI registry since June 2007. She is enrolled in Medicare PECOS and is a graduate of Saint Louis University School Of Medicine (2002).
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jessie Lyn Bartolome Roraldo 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.
Medicare Billing Reassignment
Medicare enrollment records show Jessie Lyn Roraldo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Los Angeles, CA 90027
- Reassigned Medicare billing, California enrollment
- 13,921 clinicians in this Medicare group
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 90033 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
LOS ANGELES, CA 90033
LOS ANGELES, CA 90033
LOS ANGELES, CA 90033
LOS ANGELES, CA 90033
LOS ANGELES, CA 90033
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 Jessie Lyn Roraldo's NPI number?
The NPI number for Jessie Lyn Roraldo is 1174725162. It was assigned to this individual provider in the NPPES registry on June 3, 2007. The provider is also known as Jessie Lyn Pangilinan Bartolome.
Where is Jessie Lyn Roraldo located?
Jessie Lyn Roraldo practices at 1200 N State St, Los Angeles, CA 90033. The listed phone number is (323) 226-7556.
What is Jessie Lyn Roraldo's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Jessie Lyn Roraldo enrolled in Medicare?
Yes. Jessie Lyn Roraldo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Jessie Lyn Roraldo's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jessie Lyn Roraldo reassigns Medicare benefits to Southern California Permanente Medical Group (Los Angeles, 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 Jessie Lyn Roraldo'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 Jessie Lyn Roraldo was last updated on October 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Jessie Lyn Bartolome Roraldo · NPI 1174725162
Internal Medicine physician in Los Angeles, California. Individual provider, active in the CMS NPPES registry since June 3, 2007.
## Identity
- **NPI:** 1174725162 (Entity type: Individual)
- **Enumerated:** June 3, 2007
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** A102737 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1200 N STATE ST, Los Angeles, CA 90033-1029
- **Phone:** (323) 226-7556
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Southern California Permanente Medical Group (NPI 1134151657, Los Angeles, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Saint Louis University School Of Medicine, class of 2002
## Record status
- **NPPES last updated:** October 14, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1174725162) · Data from the CMS NPPES public registry.