Individual provider Active NPI

Katrina Blackburn Mitchell, M.D.

  • Surgical Oncology Physician
  • Santa Barbara, CA
National Provider Identifier
1225233760
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
C161065 Issued in CA
Practice address
540 W Pueblo St
Santa Barbara, CA 93105
Phone
(805) 879-0670
NPI assigned
Jun 15, 2007
Last updated
Sep 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X C161065 CA Primary

Addresses

Primary practice location

540 W Pueblo St
Santa Barbara, CA 93105

Mailing address

PO Box 62106
Santa Barbara, CA 93160-2106
Phone (805) 681-1872

Other practice location 1

4411 The 25 Way NE
Suite 150
Albuquerque, NM 87109-5857
Phone (505) 559-6100

Other identifiers 1

IdentifierTypeStateIssuer
346373901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150604000357 TX Practitioner - General Surgery 6800117722 Reassigns benefits to 1 organization
I20191025001498 CA Practitioner - Surgical Oncology 6800117722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
Geisel School of Medicine at Dartmouth, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sansum ClinicGroup PAC ID 3678471976, 320 clinicians

Practice addresses (Care Compare)

540 W Pueblo St
Santsa Barbara, CA 93105-4310
Phone (805) 681-1761

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy78
Melanoma (skin cancer) excision61
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C161065CAMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Referral Service CurrentSince Jul 1, 2015 Accepting new patients
Sansum Clinic CurrentSince Sep 17, 2019 Accepting new patients
Sansum Clinic Current Accepting new patients
Sansum Clinic CurrentSince Sep 17, 2019 Accepting new patients
Santa Barbara Cottage Hospital Past Accepting new patients
Sansum Clinic Past Accepting new patients
Goleta Valley Cottage Hospital Past Accepting new patients

Locations

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

317 W Pueblo St
Santa Barbara, CA 93105
Phone (805) 681-7500

540 W Pueblo St
Santa Barbara, CA 93105
Phone (805) 563-5800

1515 Holcombe Blvd
Houston, TX 77030
Phone (713) 794-5446

Interoperability endpoints

  • Direct secure messaging: kmitchell760653@hisp.ehr.sutterhealth.org

Organizations & group practices 7

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": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1225233760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62106",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931602106",
            "telephone_number": "805-681-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 W PUEBLO ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "93105",
            "telephone_number": "805-879-0670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4411 The 25 Way NE",
            "address_2": "Suite 150",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871095857",
            "country_code": "US",
            "telephone_number": "505-559-6100",
            "fax_number": "505-332-5847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "KATRINA",
        "middle_name": "BLACKBURN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "CA",
            "license": "C161065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "346373901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.