NPIMap

Individual provider Active NPI

Samuel Branch Kieley, M.D.

  • Urology Physician
  • Santa Maria, CA
National Provider Identifier
1003058546
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A130815 Issued in CA
Practice address
116 S Palisade Dr Ste 110
Santa Maria, CA 93454-8905
Phone
(805) 349-7133
Fax
(805) 349-7137
NPI assigned
Mar 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A130815 CA Primary

Addresses

Primary practice location

116 S Palisade Dr Ste 110
Santa Maria, CA 93454-8905

Mailing address

225 Prado Rd Ste D
San Luis Obispo, CA 93401-7363
Phone (805) 786-2500

Other practice location 1

921 Oak Park Blvd Ste 202
Pismo Beach, CA 93449-3400
Phone (805) 473-7818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141002000636 CA Practitioner - Urology 5890937940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Chicago College of Medicine and Surgery, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

116 S Palisade Dr
Suite 110
Santa Maria, CA 93454-8905
Phone (805) 349-7133

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Associates of the Central Coast Urology CurrentSince Sep 1, 2014 Accepting new patients
Urology Associates of the Central Coast Urology CurrentSince Sep 1, 2014 Accepting new patients
Dignity Health Past Accepting new patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients
Lompoc Valley Medical Center Past Accepting new patients
Dignity Community Care Past Accepting new patients
Twin Cities Community Hospital, Inc. Past Accepting new patients

Locations

1111 E Ocean Ave
Ste 3
Lompoc, CA 93436
Phone (805) 733-8150

921 Oak Park Blvd
Ste 202
Pismo Beach, CA 93449
Phone (805) 473-7818

116 S Palisade Dr
Ste 110
Santa Maria, CA 93454
Phone (805) 349-7133

225 Prado Rd
Ste D
Sn Luis Obisp, CA 93401
Phone 8057862500 ext. 1021

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/9c3d5f6c-4d59-4a7f-9170-c96c3d9e561c/

Organizations & group practices 7

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1003058546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 PRADO RD STE D",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017363",
            "telephone_number": "805-786-2500",
            "fax_number": "805-781-0423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S PALISADE DR STE 110",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934548905",
            "telephone_number": "805-349-7133",
            "fax_number": "805-349-7137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "921 Oak Park Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Pismo Beach",
            "state": "CA",
            "postal_code": "934493400",
            "country_code": "US",
            "telephone_number": "805-473-7818",
            "fax_number": "805-473-7820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIELEY",
        "first_name": "SAMUEL",
        "middle_name": "BRANCH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-30",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A130815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.