CHRISTIAN CUSTODIO FNP
NPI 1811502404
Nurse Practitioner - Primary Care in Pomona, CA
About Christian Custodio Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CHRISTIAN CUSTODIO FNP (NPI 1811502404) is an individual primary care provider in Pomona, California, licensed in California (95015354) and active in the NPI registry since September 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses
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
Christian Custodio Fnp 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.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 91768 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims
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 Christian Custodio's NPI number?
The NPI number for Christian Custodio is 1811502404. It was assigned to this individual provider in the NPPES registry on September 10, 2020.
Where is Christian Custodio located?
Christian Custodio practices at 1196 N Park Ave, Pomona, CA 91768. The listed phone number is (909) 623-4050.
What is Christian Custodio's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is Christian Custodio enrolled in Medicare?
Yes. Christian Custodio 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.
When was this NPI record last updated?
The NPPES record for Christian Custodio was last updated on September 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Christian Custodio, FNP · NPI 1811502404
Primary Care physician in Pomona, California. Individual provider, active in the CMS NPPES registry since September 10, 2020.
## Identity
- **NPI:** 1811502404 (Entity type: Individual)
- **Enumerated:** September 10, 2020
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **State license:** 95015354 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 1196 N PARK AVE, Pomona, CA 91768-3027
- **Phone:** (909) 623-4050
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** September 10, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1811502404) · Data from the CMS NPPES public registry.