Individual provider Active NPI

Brittany Lopez

  • Physician Assistant
  • Santa Maria, CA
National Provider Identifier
1265046155
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
60631 Issued in CA
Practice address
1745 N Broadway Ste 101
Santa Maria, CA 93454-1940
Phone
(805) 739-3890
Fax
(805) 347-7697
NPI assigned
Sep 8, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 60631 CA Primary

Addresses

Primary practice location

1745 N Broadway Ste 101
Santa Maria, CA 93454-1940

Mailing address

1745 N Broadway Ste 101
Santa Maria, CA 93454-1940
Phone (805) 739-3890

Other practice location 1

50 Acacia Ave
San Rafael, CA 94901-2230
Phone (415) 457-4440

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220408000849 CA Practitioner - Physician Assistant 4183010622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1510 E Main St
Suite 104 C
Santa Maria, CA 93454-4825
Phone (805) 349-8514

1745 N Broadway
Suite 101
Santa Maria, CA 93454-1940
Phone (805) 739-3890

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
60631CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Central Coast Health Centers CurrentSince May 9, 2022 Accepting new patients
Pacific Central Coast Health Centers CurrentSince May 9, 2022 Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients

Locations

1414 E Main St
Ste 201
Santa Maria, CA 93454
Phone (805) 739-3112

117 W Bunny Ave
Santa Maria, CA 93458
Phone (805) 739-3474

1510 E Main St
Ste 104C
Santa Maria, CA 93454
Phone (805) 349-8514

1745 N Broadway
Ste 101
Santa Maria, CA 93454

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1265046155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 N BROADWAY STE 101",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934541940",
            "telephone_number": "805-739-3890",
            "fax_number": "805-347-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 N BROADWAY STE 101",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934541940",
            "telephone_number": "805-739-3890",
            "fax_number": "805-347-7697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Acacia Ave",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949012230",
            "country_code": "US",
            "telephone_number": "415-457-4440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "BRITTANY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-08",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "60631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.