Charles B. Fishman, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

C 31365 Issued in CA

Practice address

1551 Bishop St
Suite 410
San Luis Obispo, CA 93401-4635

Phone

(805) 541-4180

Fax

(805) 541-2542

NPI assigned

Sep 24, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Dermatology

Education

Indiana University School of Medicine, 1968

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Luis Dermatology, Inc.Group PAC ID 5496700767, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107

Merit-based Incentive Payment System (MIPS)

Final score

86.58 of 100Reported as group

Quality

96.73

Improvement activities

40

Cost

59.63

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• San Luis Dermatology, Inc.

  • Dermatology Physician
  • San Luis Obispo, CA
  • NPI 1568431500
  Medicare reassignment Care Compare group NPD
• Charles B. Fishman, M.D., a Professional Corporation

  • Dermatology Physician
  • San Luis Obispo, CA
  • NPI 1255528113
  Authorized official Same address or phone
• R Jeffrey Herten MD Inc

  • Dermatology Physician
  • San Luis Obispo, CA
  • NPI 1730279944
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Health

  • General Acute Care Hospital
  • Santa Maria, CA
  • NPI 1760510937
  Care Compare affiliation

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194825752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 BISHOP ST",
            "address_2": "SUITE 410",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014635",
            "telephone_number": "805-541-4180",
            "fax_number": "805-541-2542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 BISHOP ST",
            "address_2": "SUITE 410",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014635",
            "telephone_number": "805-541-4180",
            "fax_number": "805-541-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHMAN",
        "first_name": "CHARLES",
        "middle_name": "B.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "C 31365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "W18438",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPIN #",
            "identifier": "WC31365A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• First Choice Physician Partners (FCPP-Central Coast Family Health-SLO)
• First Choice Physician Partners (Central Coast Associated Physicians Inc)
• First Choice Physician Partners (Obstetrics and Gynecology at Sierra Vista)
• James Brian Fishback, PH.D.
• Robert Irl Fishburn, MD
• Sarah Fishman
• Dennis Craig Fitch, DDS
• Kelly Irene Fitzgerald, LMFT
• Karen Flaherty
• Marianne Kay Flak

• Dermatology Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.