Mario Fernando San Bartolome Jr., MD

Primary specialty

Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X

License

A89818 Issued in CA

Practice address

5405 Garden Grove Blvd Ste 102
Westminster, CA 92683-1887

Phone

(714) 598-3707

Fax

(714) 422-0260

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Addiction MedicineAlso: Preventive Medicine

Education

University of California, Irvine, California College of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

KCS, Inc.Group PAC ID 0446495105, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• KCS, Inc.

  • Federally Qualified Health Center (FQHC)
  • Buena Park, CA
  • NPI 1861525602
  Medicare reassignment Care Compare group NPD
• KCS, Inc.

  • Federally Qualified Health Center (FQHC)
  • Irvine, CA
  • NPI 1932746864
  NPD
• First Choice Physician Partners

  • Internal Medicine Physician
  • Modesto, CA
  • NPI 1912264862
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1154420024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 GARDEN GROVE BLVD STE 102",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926831887",
            "telephone_number": "714-598-3707",
            "fax_number": "714-422-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 GARDEN GROVE BLVD STE 102",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926831887",
            "telephone_number": "714-598-3707",
            "fax_number": "714-422-0260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN BARTOLOME",
        "first_name": "MARIO",
        "middle_name": "FERNANDO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "CA",
            "license": "A89818",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "A89818",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A89818",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "CA",
            "license": "A89818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Salazar
• Martha Saldivar
• Ranya Salib, RPH
• Dennis I Saller, L.E.P.
• Jacob Edward Samuelson, DC
• Zuly Sanchez Martinez
• Ashley June Sanchez, MSW INTERN, RADT
• Brenda Sanchez
• Francis Sanchez
• Joy Sanchez

• Addiction Medicine (Preventive Medicine) Physician in Westminster, CA
• Providers in Westminster, CA by specialty
• Addiction Medicine (Preventive Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.