Active NPI
Jon Walter Maclean, DO
- Pediatrics Physician
- Santa Maria, CA
National Provider Identifier
1003827825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 20A6626
- Practice address
- 1420 S Miller St
Suite J
Santa Maria, CA 93454-6959 - Phone
- (805) 922-3573
- Fax
- (805) 922-7972
- NPI assigned
- Aug 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 20A6626 | CA | Primary |
Addresses
Primary practice location
1420 S Miller St
Suite J
Santa Maria, CA 93454-6959
Mailing address
1420 S Miller St
Santa Maria, CA 93454-6959
Phone (805) 922-3573
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00AX66260 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A6626 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robert S. Barry, M.D., Inc | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Santa Maria, CA
- NPI 1366574048
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328832000000",
"number": "1003827825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1420 S MILLER ST",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "934546959",
"telephone_number": "805-922-3573",
"fax_number": "805-922-7972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 S MILLER ST",
"address_2": "SUITE J",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "934546959",
"telephone_number": "805-922-3573",
"fax_number": "805-922-7972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACLEAN",
"first_name": "JON",
"middle_name": "WALTER",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-10",
"last_updated": "2012-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "20A6626",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00AX66260",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Maria, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.