JOHN S. EDELEN M.D.
NPI 1831183383
Internal Medicine - Cardiovascular Disease in Orinda, CA

Active since September 09, 2005PECOS EnrolledAccepts Medicare Assignment
82.39/100
CMS Quality Rating
15 ALTARINDA RD STE 112, ORINDA, CA 94563(707) 718-5988 Get Directions Write a Review

NPPES record last updated: June 24, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 24, 2025, May 22, 2025, Apr 11, 2025 and 2 more (5 updates tracked since 2017).

About John S. Edelen M.d. NPPES

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

JOHN S. EDELEN M.D. (NPI 1831183383) is an individual cardiovascular disease provider in Orinda, California, licensed in California (G26272) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS and is a graduate of Columbia University College Of Physicians And Surgeons (1969).

NPPES Registry Identity

NPI1831183383
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameJOHN S. EDELENCredential: M.D.
Location Address15 ALTARINDA RD STE 112Orinda, CA 94563-2607
Mailing AddressPo Box 130Vacaville, CA 95696-0130 · (707) 718-5988
Sole ProprietorNo
Medical School CMSColumbia University College Of Physicians And SurgeonsGraduated 1969
Enumeration DateSeptember 9, 2005
Last NPPES UpdateJune 24, 20255 updates tracked since enumeration
NPPES CertifiedJune 24, 2025
NPI 1831183383 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License Licensed in CA · G26272
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
15 ALTARINDA RD STE 112, Orinda, CA 94563

Other Identifiers 1

Medicaid00G262720CA

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

John S. Edelen M.d. 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 ID6507763133
PECOS Enrollment IDI20100921001138
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.

Areas of Expertise CMS Part B claims 28

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
578 services354 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
296 services175 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
272 services265 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
227 services97 patients
Evaluation of implantable heart and blood vessel monitoring system, remote up to 30 days 93297
This service involves remotely monitoring your heart and blood vessel implant system for up to 30 days. Using advanced technology, healthcare professionals can track the device's performance and your health status, ensuring the system is working optimally for your needs.
221 services36 patients
Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days 93294
This procedure evaluates your pacemaker system remotely for up to 90 days. It checks whether single, dual, multiple lead, or leadless pacemakers are working properly. It's a safe, convenient way to ensure your heart device is functioning optimally.
214 services77 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94563 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
$153.83 typical visit price
range $69.00 – $202.35
Typical copayment $38.45 (range $17.25 – $50.58)
Most-billed visit code 99204
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

82.39/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality63.02
Improvement Activities40
Cost64.31

Other Providers at the Same Location NPPES

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

Clinical Nurse Specialist
15 ALTARINDA RD STE 112
ORINDA, CA 94563

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 John Edelen's NPI number?

The NPI number for John Edelen is 1831183383. It was assigned to this individual provider in the NPPES registry on September 9, 2005.

Where is John Edelen located?

John Edelen practices at 15 Altarinda Rd Ste 112, Orinda, CA 94563. The listed phone number is (707) 718-5988.

What is John Edelen's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is John Edelen enrolled in Medicare?

Yes. John Edelen 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 John Edelen was last updated on June 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.