Mary Nicole Lillian Lipscomb, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

60009 Issued in CA

Practice address

2271 S Depot St
Santa Maria, CA 93455-1216

Phone

(805) 739-3805

Fax

(805) 739-3806

NPI assigned

Jun 5, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Diemert Former name

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Central Coast Health CentersGroup PAC ID 9739091364, 247 clinicians

Central Coast Orthopedic Medical GroupGroup PAC ID 8426945916, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107
• French Hospital Medical Center Hospital, San Luis Obispo, CA, CCN 050232

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdiemert@centralcoastortho.emadirect.md

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.

• Central Coast Orthopedic Medical Group

  • Orthopaedic Surgery Physician
  • San Luis Obispo, CA
  • NPI 1871537779
  Medicare reassignment Care Compare group
• Pacific Central Coast Health Centers

  • Community Health Clinic/Center
  • Santa Maria, CA
  • NPI 1063496651
  Medicare reassignment Care Compare group
• Pacific Central Coast Health Centers

  • Community Health Clinic/Center
  • Oxnard, CA
  • NPI 1811345960
  NPD
• Pacific Central Coast Health Centers

  • Community Health Clinic/Center
  • Arroyo Grande, CA
  • NPI 1831764117
  NPD
• Pacific Central Coast Health Centers

  • Community Health Clinic/Center
  • Bakersfield, CA
  • NPI 1720752355
  NPD (past)

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

• Dignity Community Care

  • General Acute Care Hospital
  • San Luis Obispo, CA
  • NPI 1881760452
  Care Compare affiliation
• 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": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1265056170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2271 S DEPOT ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934551216",
            "telephone_number": "805-739-3805",
            "fax_number": "805-739-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2271 S DEPOT ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934551216",
            "telephone_number": "805-739-3805",
            "fax_number": "805-739-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPSCOMB",
        "first_name": "MARY",
        "middle_name": "NICOLE LILLIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "60009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "DIEMERT",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie Norris Lin, M.D.
• Jennifer Lee Lindley
• James Michael Lindsey, M.D.
• Deja Charita Linton, PT, DPT
• Annalisa Lipes
• Merrie D Lipton, LMFT
• Scott Philip Lirgg, MD
• Sabina Lirtsman
• Angelia Marie Littig, PT, DPT
• Erica Cheng Liu, PA-C

• Physician Assistant in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; 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.