Individual provider Active NPI

John Barry Siebenlist, M.D.

  • Procedural Dermatology Physician
  • San Luis Obispo, CA
National Provider Identifier
1164476909
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
A61826 Issued in CA
Practice address
1551 Bishop St
Suite 220
San Luis Obispo, CA 93401-4635
Phone
(805) 541-0668
Fax
(805) 541-8213
NPI assigned
May 19, 2006
Last updated
Mar 16, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology Physician 207NS0135X A61826 CA Primary
MOHS-Micrographic Surgery Physician 207ND0101X A61826 CA

Addresses

Primary practice location

1551 Bishop St
Suite 220
San Luis Obispo, CA 93401-4635

Mailing address

2285 Corporate Cir
Ste 200
Henderson, NV 89074-7759
Phone (702) 360-2763

Other identifiers 1

IdentifierTypeStateIssuer
P00146047OtherCARAILROAD MEDICARE

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
I20080122000832 CA Practitioner - Dermatology 2062593510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J Robert West MD IncGroup PAC ID 8729990973, 141 clinicians

Practice addresses (Care Compare)

400 Newport Ctr Dr
Suite 702
Newport Beach, CA 92660-7669
Phone (949) 644-0101

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.17 of 100Reported as group
Quality
74.51
Promoting interoperability
92
Improvement activities
40
Cost
82.72

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision403
Removal of skin lesions665
Removal of skin cancer785
Skin biopsy183

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A61826CAMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
J Robert West, M.D., Inc Mohs-Micrographic Surgery CurrentSince Jul 30, 2007 Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients
J. Robert West, M.D., Inc Mohs-Micrographic Surgery Past Accepting new patients
J. Robert West, M.D., Inc Past Accepting new patients
West Dermatology of Northern California, Inc Procedural Dermatology Past Accepting new patients
Dignity Community Care Past Accepting new patients
West Dermatology of Arizona, Inc Past Accepting new patients

Locations

29525 Canwood St
Ste 220
Agoura Hills, CA 91301
Phone (818) 706-3744

200 Station Way
Ste E
Arroyo Grande, CA 93420
Phone (805) 202-7336

6700 N 1st St
Ste 131
Fresno, CA 93710
Phone (559) 432-3333

23521 Paseo de Valencia
Ste 302
Laguna Hills, CA 92653
Phone (949) 855-1007

26732 Crown Valley Pkwy
Ste 411
Mission Viejo, CA 92691
Phone (714) 364-2922

400 Newport Center Dr
Ste 702
Newport Beach, CA 92660
Phone (949) 644-0101

3231 Waring Ct
Ste P
Oceanside, CA 92056
Phone (760) 630-9042

340 S Farrell Dr
Ste A205
Palm Springs, CA 92262
Phone (760) 325-5588

22032 El Paseo
Ste 220
Rcho Sta Marg, CA 92688
Phone (949) 407-5184

1300 Avenida Vista Hermosa
Ste 240
San Clemente, CA 92673
Phone (949) 489-4290

550 Washington St
Ste 601
San Diego, CA 92103
Phone (619) 543-0500

805 Aerovista Pl
Ste 202
San Luis Obispo, CA 93401
Phone (805) 541-0668

116 S Palisade Dr
Ste 208
Santa Maria, CA 93454
Phone (805) 347-2100

1551 Bishop St
Ste 220
Sn Luis Obisp, CA 93401
Phone (805) 541-0668

13207 Ventura Blvd
Ste 3B
Studio City, CA 91604
Phone (818) 907-0502

2285 Corporate Cir
Ste 200
Henderson, NV 89074
Phone (702) 360-2763

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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 2

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1164476909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 CORPORATE CIR",
            "address_2": "STE 200",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747759",
            "telephone_number": "702-360-2763",
            "fax_number": "949-783-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 BISHOP ST",
            "address_2": "SUITE 220",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014635",
            "telephone_number": "805-541-0668",
            "fax_number": "805-541-8213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEBENLIST",
        "first_name": "JOHN",
        "middle_name": "BARRY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A61826",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "A61826",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00146047",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.