Individual provider Active NPI

Cecily Bosma, PA-C

  • Physician Assistant
  • Santa Barbara, CA
National Provider Identifier
1063468338
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18424 Issued in CA
Practice address
4151 Foothill Rd
Santa Barbara, CA 93110-1110
Phone
(805) 681-7564
Fax
(805) 681-7811
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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 PA18424 CA Primary

Addresses

Primary practice location

4151 Foothill Rd
Santa Barbara, CA 93110-1110

Mailing address

PO Box 62106
Santa Barbara, CA 93160-2106
Phone (805) 681-1760

Other identifiers 1

IdentifierTypeStateIssuer
PA18424OtherCAMEDICAL LICENSE

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
I20060705000099 CA Practitioner - Physician Assistant 4880606144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sansum ClinicGroup PAC ID 3678471976, 320 clinicians

Practice addresses (Care Compare)

2040 Viborg Rd
Suite 140
Solvang, CA 93463-2272
Phone (805) 681-1761

215 Pesetas LN
Santa Barbara, CA 93110-1416
Phone (805) 681-7800

Hospital & facility affiliations

  • Santa Ynez Valley Cottage Hospital Hospital, Solvang, CA, CCN 051331

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18424CAMDGeneral Practice Dentistry
PA18424CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sansum Clinic CurrentSince Jan 23, 2012 Accepting new patients
Santa Barbara Cottage Hospital Past Accepting new patients
Sansum Clinic Past Accepting new patients

Locations

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

4151 Foothill Rd
Santa Barbara, CA 93110
Phone (805) 681-1760

Interoperability endpoints

  • Direct secure messaging: cbosma760387@hisp.ehr.sutterhealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1063468338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62106",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931602106",
            "telephone_number": "805-681-1760",
            "fax_number": "805-681-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4151 FOOTHILL RD",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931101110",
            "telephone_number": "805-681-7564",
            "fax_number": "805-681-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSMA",
        "first_name": "CECILY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA18424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA18424",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.