Active NPI
Marcus Lee David Sickelton, PA
- Physician Assistant
- Santa Barbara, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA1028
- Practice address
- 400 W Pueblo St
Santa Barbara, CA 93105-4353 - Phone
- (805) 682-7111
- NPI assigned
- Aug 28, 2020
- Last updated
- Jun 6, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA201952 | OR | |
| Physician Assistant | 363A00000X | PA1028 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | OR |
Addresses
Primary practice location
400 W Pueblo St
Santa Barbara, CA 93105-4353
Mailing address
18565 W Baseline Rd Apt 508
Beaverton, OR 97006-2941
Phone (805) 423-1064
Other practice location 1
2700 NW Stewart Pkwy
Roseburg, OR 97471-1214
Phone (541) 673-0611
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1708 S Victoria Ave
Suite D
Ventura, CA 93003-6594
Phone (805) 290-4985
1846 N Broadway
Suite a
Santa Maria, CA 93454-1447
Phone (805) 361-4279
3885 State St
Suite a
Santa Barbara, CA 93105-5645
Phone (805) 569-7351
777 E Foothill Blvd
San Luis Obispo, CA 93405-1617
Phone (805) 762-4348
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.69 of 100
- Quality
- 90
- Improvement activities
- 40
- Cost
- 78.43
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA1028 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America - California | Current | Accepting new patients | |
| Cep America-California | Current | Accepting new patients | |
| Cep America - California | Current | Accepting new patients | |
| Cottage Medical Associates | Past | Accepting new patients |
Locations
2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051
1911 Johnson Ave
Sn Luis Obisp, CA 93401
Phone (805) 542-6633
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.
-
dba Cottage Urgent Care
- Urgent Care Clinic/Center
- Santa Barbara, CA
- NPI 1588209357
-
- Emergency Medicine Physician
- Murrieta, CA
- NPI 1588552848
-
- Internal Medicine Physician
- Santa Barbara, CA
- NPI 1972669562
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686009600000",
"number": "1245843143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18565 W BASELINE RD APT 508",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970062941",
"telephone_number": "805-423-1064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 W PUEBLO ST",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931054353",
"telephone_number": "805-682-7111"
}
],
"practiceLocations": [
{
"address_1": "2700 NW Stewart Pkwy",
"address_purpose": "LOCATION",
"city": "Roseburg",
"state": "OR",
"postal_code": "974711214",
"country_code": "US",
"telephone_number": "541-673-0611",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SICKELTON",
"first_name": "MARCUS",
"middle_name": "LEE DAVID",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-28",
"last_updated": "2023-06-06",
"certification_date": "2023-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OR",
"license": "PA201952",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA1028",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "OR",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Barbara, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.