WELLAH MARIE SOMBILLA SAN BUENAVENTURA
NPI 1548806953
Nurse Practitioner - Gerontology in Atwater, CA
About Wellah Marie Sombilla San Buenaventura NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WELLAH MARIE SOMBILLA SAN BUENAVENTURA (NPI 1548806953) is an individual gerontology provider in Atwater, California, licensed in California (95013309) and active in the NPI registry since November 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses
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
Wellah Marie Sombilla San Buenaventura 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 Wellah Marie San Buenaventura reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Gustine, CA 95322
- Reassigned Medicare billing, California enrollment
- 179 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 95301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Referred Medical Equipment & Supplies CMS DME claims 9
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Wellah Marie San Buenaventura's NPI number?
The NPI number for Wellah Marie San Buenaventura is 1548806953. It was assigned to this individual provider in the NPPES registry on November 20, 2019.
Where is Wellah Marie San Buenaventura located?
Wellah Marie San Buenaventura practices at 1775 3rd St, Atwater, CA 95301. The listed phone number is (209) 358-5611.
What is Wellah Marie San Buenaventura's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.
Is Wellah Marie San Buenaventura enrolled in Medicare?
Yes. Wellah Marie San Buenaventura 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 Wellah Marie San Buenaventura's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Wellah Marie San Buenaventura reassigns Medicare benefits to Community Health Centers Of America (Gustine, 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 Wellah Marie San Buenaventura'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 Wellah Marie San Buenaventura was last updated on November 20, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Wellah Marie Sombilla San Buenaventura · NPI 1548806953
Gerontology physician in Atwater, California. Individual provider, active in the CMS NPPES registry since November 20, 2019.
## Identity
- **NPI:** 1548806953 (Entity type: Individual)
- **Enumerated:** November 20, 2019
- **Primary specialty:** Nurse Practitioner - Gerontology · taxonomy 363LG0600X
- **State license:** 95013309 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 1775 3RD ST, Atwater, CA 95301-3608
- **Phone:** (209) 358-5611
## 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:** Community Health Centers Of America (NPI 1245105733, Gustine, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** November 20, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1548806953) · Data from the CMS NPPES public registry.