Individual provider Active NPI

Deborah A. Cherry, M.D.

  • Internal Medicine Physician
  • San Luis Obispo, CA
National Provider Identifier
1063495356
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G61844 Issued in CA
Practice address
4251 S Higuera St Ste 701
San Luis Obispo, CA 93401-7742
Phone
(805) 439-1381
Fax
(805) 439-0138
NPI assigned
Nov 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G61844 CA Primary

Addresses

Primary practice location

4251 S Higuera St Ste 701
San Luis Obispo, CA 93401-7742

Mailing address

4251 S Higuera St Ste 701
San Luis Obispo, CA 93401-7742
Phone (805) 439-1381

Other identifiers 6

IdentifierTypeStateIssuer
00G618440OtherCABLUE SHIELD LEGACY PIN
00G618440OtherCABLUE SHIELD OF CA PIN
ORR004OtherSLO SELECT
05D0996840OtherCACLIA
1109232696OtherRAILROAD MEDICARE
635978OtherFIRST HEALTH LEGACY PIN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070605000514 CA Practitioner - Internal Medicine 4284651811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, Irvine, California College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

805 Aerovista PL
San Luis Obispo, CA 93401-7921
Phone (805) 594-1240

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.08 of 100Reported as individual
Quality
77.69
Promoting interoperability
97
Improvement activities
40
Cost
55.09

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions23
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G61844CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctor Yu Dental Corporation CurrentSince Dec 22, 2025 Accepting new patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients

Locations

805 Aerovista Pl
Ste 106
Sn Luis Obisp, CA 93401
Phone (805) 544-7804

Organizations & group practices 3

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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1063495356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4251 S HIGUERA ST STE 701",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017742",
            "telephone_number": "805-439-1381",
            "fax_number": "805-439-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4251 S HIGUERA ST STE 701",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017742",
            "telephone_number": "805-439-1381",
            "fax_number": "805-439-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERRY",
        "first_name": "DEBORAH",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G61844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD LEGACY PIN",
            "identifier": "00G618440",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA PIN",
            "identifier": "00G618440",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SLO SELECT",
            "identifier": "ORR004",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D0996840",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "1109232696",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH LEGACY PIN",
            "identifier": "635978",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.