Individual provider Active NPI

Robert Cunningham Streeter IV, MD

  • Family Medicine Physician
  • Camarillo, CA
National Provider Identifier
1154432151
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G68874 Issued in CA
Practice address
1040 Flynn Rd
Camarillo, CA 93012-5092
Phone
(805) 673-3930
Fax
(805) 659-3217
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G68874 CA Primary

Addresses

Primary practice location

1040 Flynn Rd
Camarillo, CA 93012-5092

Mailing address

1040 Flynn Rd
Camarillo, CA 93012-5092
Phone (805) 673-3930

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
I20080627000288 CA Practitioner - Family Practice 6709853740 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Pennsylvania State University College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Memorial Health SystemGroup PAC ID 9537155676, 187 clinicians

Practice addresses (Care Compare)

120 N Ashwood Ave
Ventura, CA 93003-1810
Phone (805) 658-5800

Hospital & facility affiliations

  • Community Memorial Hospital - Ojai Hospital, Ojai, CA, CCN 051334
  • Community Memorial Hospital - Ventura Hospital, Ventura, CA, CCN 050394

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68874CAMDPharmacist
G68874CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Memorial Health System CurrentSince Nov 1, 2024 Accepting new patients
Clinicas del Camino Real Inc Current Accepting new patients
Community Memorial Health System Current Accepting new patients
Community Memorial Health System CurrentSince Nov 1, 2024 Accepting new patients
Clinicas del Camino Real Inc CurrentSince Aug 15, 2022 Accepting new patients
Clinicas del Camino Real Inc CurrentSince Aug 15, 2022 Accepting new patients
Clinicas del Camino Real Inc PastSince Aug 28, 2022 Accepting new patients
Clinicas del Camino Real Inc PastSince Aug 28, 2022 Accepting new patients

Locations

422 Arneill Rd
Ste B
Camarillo, CA 93010
Phone (805) 383-4510

2921 Saviers Rd
Oxnard, CA 93033
Phone (805) 487-5588

500 E Main St
Santa Paula, CA 93060
Phone (805) 933-0895

120 N Ashwood Ave
Ventura, CA 93003
Phone (805) 658-5800

147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011

5855 Olivas Park Dr
Ventura, CA 93003
Phone (805) 652-5469

200 S Wells Rd
Ventura, CA 93004
Phone (805) 647-6322

138 W Main St
Ste E
Ventura, CA 93001
Phone (805) 667-2850

Interoperability endpoints

  • Direct secure messaging: rstreeter3529984@oc.providencedirect.org

Ownership & related parties

All facility ownership & control disclosures 14

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Livingston Memorial VnaVentura, CA, CCN 057040 Home health agency Corporate Director Apr 1, 2017
Livingston Memorial Vna HospiceVentura, CA, CCN 051517 Hospice Corporate Director Apr 1, 2017
Clinicas del Camino Real, Inc MaravillaOxnard, CA, CCN 551851 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Aug 15, 2022
Aug 15, 2022
Aug 15, 2022
Clinicas del Camino Real, Inc. OxnardOxnard, CA, CCN 051827 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Aug 15, 2022
Aug 15, 2022
Aug 15, 2022
Clinicas del Camino Real Inc, Newbury ParkNewbury Park, CA, CCN 051115 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Aug 15, 2022
Aug 15, 2022
Aug 15, 2022
Clinicas del Camino Real Inc El RioOxnard, CA, CCN 051172 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Aug 15, 2022
Aug 15, 2022
Aug 15, 2022
Clinicas del Camino Real , Inc VenturaVentura, CA, CCN 051861 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Aug 15, 2022
Aug 15, 2022
Aug 15, 2022
Clinicas del Camino Real Inc, Ocean ViewOxnard, CA, CCN 551939 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Aug 15, 2022
Aug 15, 2022
Aug 15, 2022
Clinicas del Camino Real, Inc Karen Burnham Health CenterOxnard, CA, CCN 051025 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Aug 15, 2022
Aug 15, 2022
Aug 15, 2022
Ojai Valley Community Health CenterOjai, CA, CCN 551850 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Aug 15, 2022
Aug 15, 2022
Aug 15, 2022
Clinicas del Camino Real Inc FillmoreFillmore, CA, CCN 051860 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Aug 15, 2022
Aug 15, 2022
Aug 15, 2022
Clinicas del Camino Real Inc. Simi ValleySimi Valley, CA, CCN 551159 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Aug 15, 2022
Aug 15, 2022
Aug 15, 2022
Clinicas del Camino Real Inc MoorparkMoorpark, CA, CCN 551172 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Aug 15, 2022
Aug 15, 2022
Aug 15, 2022
Clinicas del Camino Real, Inc-Roberto S Juarez Health CenterOxnard, CA, CCN A01815 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Aug 15, 2022
Aug 15, 2022
Aug 15, 2022

Owned or controlled facilities with NPI records 14

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 14

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 11

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1154432151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 FLYNN RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125092",
            "telephone_number": "805-673-3930",
            "fax_number": "805-659-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 FLYNN RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125092",
            "telephone_number": "805-673-3930",
            "fax_number": "805-659-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREETER",
        "first_name": "ROBERT",
        "middle_name": "CUNNINGHAM",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G68874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

Verify at the official NPI Registry.