Individual provider Active NPI

Martha C Salcido, PA

  • Physician Assistant
  • Lompoc, CA
National Provider Identifier
1013237866
Registry record updated Dec 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 20298 Issued in CA
Practice address
425 W Central Ave
Lompoc, CA 93436-2805
Phone
(805) 737-1774
Fax
(805) 737-1772
NPI assigned
Jun 3, 2010
Last updated
Dec 7, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 20298 CA Primary

Addresses

Primary practice location

425 W Central Ave
Lompoc, CA 93436-2805

Mailing address

150 Tejas PL
PO Box 430
Nipomo, CA 93444-9123
Phone (805) 929-3211

Other identifiers 1

IdentifierTypeStateIssuer
CMM71074FMedicaidCA

Other names 1

  • Martha C Hernandez Other name

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121227000303 CA Order and Referring Only - Physician Assistant 2860645835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 20298CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Central Coast Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: martha.salcido.1@17363.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354838400000",
    "number": "1013237866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 TEJAS PL",
            "address_2": "PO BOX 430",
            "city": "NIPOMO",
            "state": "CA",
            "postal_code": "934449123",
            "telephone_number": "805-929-3211",
            "fax_number": "805-929-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W CENTRAL AVE",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934362805",
            "telephone_number": "805-737-1774",
            "fax_number": "805-737-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALCIDO",
        "first_name": "MARTHA",
        "middle_name": "C",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2012-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 20298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMM71074F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTHA",
            "last_name": "HERNANDEZ",
            "middle_name": "C",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lompoc, CA

Sources for this page

Verify at the official NPI Registry.