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BEN ARNOLD ADOM NP
NPI 1417473034
Registered Nurse in Hesperia, CA

Active since August 15, 2017PECOS Enrolled
12021 JACARANDA AVE STE 101, HESPERIA, CA 92345(760) 956-5057(760) 947-2057 Get Directions Write a Review

NPPES record last updated: August 9, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 9, 2023, Jul 21, 2022, Aug 15, 2017 (3 updates tracked since 2017).

About Ben Arnold Adom Np NPPES

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

BEN ARNOLD ADOM NP (NPI 1417473034) is an individual registered nurse in Hesperia, California, licensed in California (95042846) and active in the NPI registry since August 2017. He is enrolled in Medicare PECOS and maintains a secondary practice location in Colton.

NPPES Registry Identity

NPI1417473034
Entity TypeIndividualMale
Primary Taxonomy163W00000X
Provider Legal NameBEN ARNOLD ADOMCredential: NP
Location Address12021 JACARANDA AVE STE 101Hesperia, CA 92345-4978
Mailing Address400 N Pepper AveColton, CA 92324-1801 · (909) 580-3145 · Fax (909) 580-2165
Phone(760) 956-5057
Fax(760) 947-2057
Sole ProprietorNo
Enumeration DateAugust 15, 2017
Last NPPES UpdateAugust 9, 20233 updates tracked since enumeration
NPPES CertifiedAugust 9, 2023
✔ NPI 1417473034 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRegistered NurseNursing Service Providers
Taxonomy Code163W00000X
License✔ Licensed in CA · 95042846
Definition
(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 95021179 (CA)
12021 JACARANDA AVE STE 101, Hesperia, CA 92345
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Secondary Practice Location 1

Location 1400 N Pepper AveColton, CA 92324-1801 · Phone (909) 580-3145 · Fax (909) 580-2165

Other Identifiers 1

Other1417473034CA · Family Practice

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ben Arnold Adom Np 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 Ben Adom reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Providence Podiatry Care, Inc
28 mi
Foot & Ankle Surgery
473 E CARNEGIE DRIVE, SUITE 200
San Bernardino, CA 92408
  • Reassigned Medicare billing, California enrollment
  • 15 clinicians in this Medicare group
NPI 1376202986 (909) 244-7430

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 3

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

DR. BRYAN ANDREW MITTON MD, PHD
Pediatrics
12021 JACARANDA AVE STE 101
HESPERIA, CA 92345
San Bernardino County (760) 956-5057
SANDRA LIMON NP
Nurse Practitioner
12021 JACARANDA AVE STE 101
HESPERIA, CA 92345
San Bernardino County (760) 956-5057
ARLENE BRAHAM MD
General Practice
12021 JACARANDA AVE STE 101
HESPERIA, CA 92345
San Bernardino County (760) 956-5174

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 Ben Adom's NPI number?

The NPI number for Ben Adom is 1417473034. It was assigned to this individual provider in the NPPES registry on August 15, 2017.

Where is Ben Adom located?

Ben Adom practices at 12021 Jacaranda Ave Ste 101, Hesperia, CA 92345. The listed phone number is (760) 956-5057.

What is Ben Adom's specialty?

The primary specialty registered for this NPI is Registered Nurse with taxonomy code 163W00000X.

Is Ben Adom enrolled in Medicare?

Yes. Ben Adom is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ben Adom's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ben Adom reassigns Medicare benefits to Providence Podiatry Care, Inc (San Bernardino, 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 Ben Adom'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 Ben Adom was last updated on August 9, 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.