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KELLY ALYSSA JEU MD
NPI 1497288724
Pediatrics in San Bernardino, CA

Active since April 04, 2017PECOS Enrolled
2150 N WATERMAN AVE STE 202, SAN BERNARDINO, CA 92404(909) 674-1600 Get Directions Write a Review

NPPES record last updated: May 19, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 19, 2025, Jun 14, 2021, Sep 16, 2020 (3 updates tracked since 2020).

About Kelly Alyssa Jeu Md NPPES

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

KELLY ALYSSA JEU MD (NPI 1497288724) is an individual pediatrics provider in San Bernardino, California, licensed in California (A157005) and active in the NPI registry since April 2017. She is enrolled in Medicare PECOS and maintains a secondary practice location in Loma Linda.

NPPES Registry Identity

NPI1497288724
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameKELLY ALYSSA JEUCredential: MD
Location Address2150 N WATERMAN AVE STE 202San Bernardino, CA 92404-4811
Mailing Address11234 Anderson St # GeneralLoma Linda, CA 92354-2804 · (909) 558-4174
Phone(909) 674-1600
Sole ProprietorNo
Enumeration DateApril 4, 2017
Last NPPES UpdateMay 19, 20253 updates tracked since enumeration
NPPES CertifiedMay 19, 2025
✔ NPI 1497288724 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A157005
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
2150 N WATERMAN AVE STE 202, San Bernardino, CA 92404
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Secondary Practice Location 1

Location 111234 Anderson St # GeneralLoma Linda, CA 92354-2804 · Phone (909) 558-4174

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Alyssa Jeu Md 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 Kelly Jeu reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Namita Mohideen MD Inc
9.5 mi
Primary Care
16465 SIERRA LAKES PKWY STE 115
Fontana, CA 92336
  • Reassigned Medicare billing, California enrollment
  • 22 clinicians in this Medicare group
NPI 1649546144 (909) 823-8000

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 92404 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 2

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

STACEY DIANE WILES MD, MPH
Pediatrics
2150 N WATERMAN AVE STE 202
SAN BERNARDINO, CA 92404
San Bernardino County (909) 674-1600
DR. EDUARDO VARGAS MD
Family Medicine
2150 N WATERMAN AVE STE 202
SAN BERNARDINO, CA 92404
San Bernardino County (909) 674-1600

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 Kelly Jeu's NPI number?

The NPI number for Kelly Jeu is 1497288724. It was assigned to this individual provider in the NPPES registry on April 4, 2017.

Where is Kelly Jeu located?

Kelly Jeu practices at 2150 N Waterman Ave Ste 202, San Bernardino, CA 92404. The listed phone number is (909) 674-1600.

What is Kelly Jeu's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Kelly Jeu enrolled in Medicare?

Yes. Kelly Jeu is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kelly Jeu's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Jeu reassigns Medicare benefits to Namita Mohideen MD Inc (Fontana, 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 Kelly Jeu'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 Kelly Jeu was last updated on May 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.