NPIMap

Organization Active NPI

Central Coast Family Care Medical Associates, Inc.

  • Family Medicine Physician
  • Santa Maria, CA
National Provider Identifier
1093467730
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CENTRAL COAST FAMILY CARE MEDICAL ASSOCIATES, INC.
Practice address
1145 E Clark Ave Ste C
Santa Maria, CA 93455-5151
Phone
(805) 387-6366
Fax
(805) 934-3707
NPI assigned
Jan 24, 2022
Organization subpart
Yes
Parent organization
CENTRAL COAST FAMILY CARE MEDICAL ASSOCIATES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Authorized official

Name
Juleen Stimson
Title
Administratio
Phone
(805) 925-1009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1145 E Clark Ave Ste C
Santa Maria, CA 93455-5151

Mailing address

1145 E Clark Ave Ste C
Santa Maria, CA 93455-5151
Phone (805) 387-6366

Other names 1

  • Central Coast Family Care 6 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040720001651 CA Part B Supplier - Clinic/Group Practice 7719967801 Receives reassigned benefits from 20 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sana Maria, CA; Santa Maria, CA

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Central Coast Family Care Medical Associates Inc8 organizations share this tax ID, including this one
Part of
Central Coast Family Care Medical Associates Inc

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1145 E Clark Ave
Ste C
Santa Maria, CA 93455
Phone (805) 332-4626

915 E Stowell Rd
Ste B
Santa Maria, CA 93454
Phone (805) 938-7424

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642982400000",
    "number": "1093467730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 E CLARK AVE STE C",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934555151",
            "telephone_number": "805-387-6366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 E CLARK AVE STE C",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934555151",
            "telephone_number": "805-387-6366",
            "fax_number": "805-934-3707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL COAST FAMILY CARE MEDICAL ASSOCIATES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL COAST FAMILY CARE MEDICAL ASSOCIATES, INC.",
        "enumeration_date": "2022-01-24",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A",
        "authorized_official_last_name": "STIMSON",
        "authorized_official_first_name": "JULEEN",
        "authorized_official_title_or_position": "ADMINISTRATIO",
        "authorized_official_telephone_number": "805-925-1009"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Coast Family Care 6",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.