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DR. NOEL NEPOMUCENO JR. M.D.
NPI 1205193521
Family Medicine - Sports Medicine in Wildomar, CA

Active since April 12, 2012PECOS EnrolledAccepts Medicare Assignment
36450 INLAND VALLEY DR, SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP, WILDOMAR, CA 92595(951) 600-3476 Get Directions Write a Review

NPPES record last updated: December 1, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Noel Nepomuceno Jr. M.d. NPPES

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

DR. NOEL NEPOMUCENO JR. M.D. (NPI 1205193521) is an individual sports medicine provider in Wildomar, California, licensed in California (A122221) and active in the NPI registry since April 2012. He is enrolled in Medicare PECOS and is a graduate of Loma Linda University School Of Medicine (2011).

NPPES Registry Identity

NPI1205193521
Entity TypeIndividualMale
Primary Taxonomy207QS0010X
Provider Legal NameDR. NOEL NEPOMUCENO JR.Credential: M.D.
Location Address36450 INLAND VALLEY DR, SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUPWildomar, CA 92595-9583
Mailing Address10976 Ragsdale RdLoma Linda, CA 92354-6545 · (909) 900-7831
Phone(951) 600-3476
Sole ProprietorNo
Medical School CMSLoma Linda University School Of MedicineGraduated 2011
Enumeration DateApril 12, 2012
Last NPPES UpdateDecember 1, 2021
✔ NPI 1205193521 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
License✔ Licensed in CA · A122221
Definition
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
36450 INLAND VALLEY DR, Wildomar, CA 92595
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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 and accepts Medicare assignment

Dr. Noel Nepomuceno Jr. M.d. 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 ID4486889508
PECOS Enrollment IDI20131028000152
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 Reassignments

2

Medicare enrollment records show Noel Nepomuceno reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Southern California Permanente Medical Group
20 mi
Health Maintenance Organization
3527 W FLORIDA AVE
Hemet, CA 92545
  • Reassigned Medicare billing, California enrollment
  • Also billed through NPI 1952333460 (California)
  • 5,228 clinicians in this Medicare group
NPI 1013433465 (877) 608-0044
Hawaii Permanente Medical Group Inc
2,616 mi
Health Maintenance Organization
3288 MOANALUA RD
Honolulu, HI 96819
  • Reassigned Medicare billing, Hawaii enrollment
  • 1,187 clinicians in this Medicare group
NPI 1710945969 (808) 432-0000

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 92595 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.

SARAH DEVINE-COOTER FNP
Nurse Practitioner (Family)
36450 INLAND VALLEY DR
WILDOMAR, CA 92595
Riverside County (866) 984-7483
DR. JAMES KABELLIS II MD
Family Medicine (Adult Medicine)
36450 INLAND VALLEY DR
WILDOMAR, CA 92595
Riverside County (833) 574-2273
BASSAM AZZAM BS PHARMACY
Pharmacist
36450 INLAND VALLEY DR
WILDOMAR, CA 92595
Riverside County (951) 600-3322
KEVIN SURESH CHANDRASENA
Internal Medicine
36450 INLAND VALLEY DR
WILDOMAR, CA 92595
Riverside County (866) 984-7483
BRUCE A. HAYTON, M.D., INC.
Specialist
36450 INLAND VALLEY DR, SUITE 101
WILDOMAR, CA 92595
Riverside County (951) 698-7514
YALDA LYNN HOWARD PHARMD
Pharmacist
36450 INLAND VALLEY DR
WILDOMAR, CA 92595
Riverside County (951) 600-3322
DR. JEE-HYON PARK M.D.
Internal Medicine
36450 INLAND VALLEY DR
WILDOMAR, CA 92595
Riverside County (866) 206-2983
DANTE GIBSON PHARM.D.
Pharmacist
36450 INLAND VALLEY DR, SUITE #209
WILDOMAR, CA 92595
Riverside County (866) 370-1940

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 Noel Nepomuceno's NPI number?

The NPI number for Noel Nepomuceno is 1205193521. It was assigned to this individual provider in the NPPES registry on April 12, 2012.

Where is Noel Nepomuceno located?

Noel Nepomuceno practices at 36450 Inland Valley Dr Southern California Permanente Medical Group, Wildomar, CA 92595. The listed phone number is (951) 600-3476.

What is Noel Nepomuceno's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Noel Nepomuceno enrolled in Medicare?

Yes. Noel Nepomuceno 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 organizations bill Medicare for Noel Nepomuceno's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Noel Nepomuceno reassigns Medicare benefits to 2 organizations: Southern California Permanente Medical Group (Hemet, CA) and Hawaii Permanente Medical Group Inc (Honolulu, HI). Each 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 Noel Nepomuceno'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 Noel Nepomuceno was last updated on December 1, 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.