MARY EDEM NP
NPI 1760787030
Nurse Practitioner - Psychiatric/Mental Health in San Bernardino, CA

Active since January 18, 2011PECOS EnrolledAccepts Medicare Assignment
190 E HIGHLAND AVE, SAN BERNARDINO, CA 92404(909) 882-4788(877) 860-7268 Get Directions Write a Review

NPPES record last updated: September 23, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 23, 2016, Sep 17, 2016, Dec 1, 2015 (3 updates tracked since 2015).

About Mary Edem Np NPPES

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

MARY EDEM NP (NPI 1760787030) is an individual psychiatric/mental health provider in San Bernardino, California, licensed in California (20107) and active in the NPI registry since January 2011. She is enrolled in Medicare PECOS and is a graduate of Other (2010).

NPPES Registry Identity

NPI1760787030
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameMARY EDEMCredential: NP
Location Address190 E HIGHLAND AVESan Bernardino, CA 92404-3658
Mailing Address200 Oceangate, Suite 100Long Beach, CA 90802-4317 · (562) 499-6191 · Fax (562) 499-6171
Fax(877) 860-7268
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateJanuary 18, 2011
Last NPPES UpdateSeptember 23, 20163 updates tracked since enumeration
NPI 1760787030 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License Licensed in CA · 20107
190 E HIGHLAND AVE, San Bernardino, CA 92404

Other Identifiers 2

Medicare PINCA205848-CA109020CA
Medicare PINCA205847-GA222ACA

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mary Edem Np 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 ID9830491737
PECOS Enrollment IDI20160108002574
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.

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 16

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

Physician Assistant (Medical)
190 E HIGHLAND AVE
SAN BERNARDINO, CA 92404
Non-Pharmacy Dispensing Site
190 E HIGHLAND AVE
SAN BERNARDINO, CA 92404
Pediatrics
190 E HIGHLAND AVE
SAN BERNARDINO, CA 92404
Family Medicine
190 E HIGHLAND AVE
SAN BERNARDINO, CA 92404
Family Medicine
190 E HIGHLAND AVE
SAN BERNARDINO, CA 92404
Family Medicine
190 E HIGHLAND AVE
SAN BERNARDINO, CA 92404
Psychologist (Clinical)
190 E HIGHLAND AVE
SAN BERNARDINO, CA 92404
Family Medicine
190 E HIGHLAND AVE
SAN BERNARDINO, CA 92404

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1760787030, enumerated as an "individual" on January 18, 2011.

The provider is located at 190 E HIGHLAND AVE SAN BERNARDINO, CA 92404 and the phone number is (909) 882-4788.

Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.

The provider might be accepting Accepts: Providence Health Plan, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.