Individual provider Active NPI

John Stevenson, M.D.

  • Anesthesiology Physician
  • San Luis Obispo, CA
National Provider Identifier
1184088254
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A155161 Issued in CA
Practice address
1911 Johnson Ave
San Luis Obispo, CA 93401-4131
Phone
(805) 543-5353
NPI assigned
Apr 5, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X A155161 CA Primary

Addresses

Primary practice location

1911 Johnson Ave
San Luis Obispo, CA 93401-4131

Mailing address

Dept la Lock Box #24757
Pasadena, CA 91185-4690
Phone (805) 783-1020

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
I20200518002724 CA Practitioner - Anesthesiology 5597196907 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of California, San Diego School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Anesthesiologists of the Central CoastGroup PAC ID 5597665018, 35 clinicians

Practice addresses (Care Compare)

1010 Murray Ave
San Luis Obispo, CA 93405-1806
Phone (805) 928-1731

300 Canal St
King City, CA 93930-3431
Phone (831) 385-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A155161CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Monterey County Memorial Hospital Single Specialty CurrentSince Aug 1, 2024 Accepting new patients
Associated Anesthesiologists of the Central Coast Single Specialty CurrentSince Jun 1, 2020 Accepting new patients
Southern Monterey County Memorial Hospital CurrentSince Aug 1, 2024 Accepting new patients

Locations

210 Canal St
King City, CA 93930
Phone (931) 385-7100

300 Canal St
King City, CA 93930
Phone (831) 385-6000

24757 Dept La Lockbox
Pasadena, CA 91185

921 Oak Park Blvd
Pismo Beach, CA 93449
Phone (805) 476-4949

921 Oak Park Blvd
Ste 101
Pismo Beach, CA 93449
Phone (805) 471-3353

1105 E Foster Rd
Ste G
Santa Maria, CA 93455
Phone (805) 937-7203

1911 Johnson Ave
Sn Luis Obisp, CA 93401
Phone (805) 542-6633

1010 Murray Ave
Sn Luis Obisp, CA 93405
Phone (805) 546-7600

1101 Las Tablas Rd
Ste K
Templeton, CA 93465
Phone (805) 434-2009

1100 Las Tablas Rd
Templeton, CA 93465
Phone (805) 434-3500

322 Posada Ln
Ste B
Templeton, CA 93465
Phone (805) 591-3344

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDEGCD

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 4

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": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1184088254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT LA LOCK BOX #24757",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911854690",
            "telephone_number": "805-783-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 JOHNSON AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014131",
            "telephone_number": "805-543-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-05",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A155161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.