Individual provider Active NPI

Christopher Wentling

  • Physician Assistant
  • Santa Barbara, CA
National Provider Identifier
1265091946
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
58545 Issued in CA
Practice address
3006 Lomita Rd
Santa Barbara, CA 93105-3320
Phone
(805) 636-1489
NPI assigned
Jun 6, 2019
Last updated
Sep 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 58545 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

3006 Lomita Rd
Santa Barbara, CA 93105-3320

Mailing address

3006 Lomita Rd
Santa Barbara, CA 93105-3320

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20191118001459 KS Practitioner - Physician Assistant 1759713480 Reassigns benefits to 1 organization
I20201020000299 CA Practitioner - Physician Assistant 1759713480 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cottage Clinical Network LLCGroup PAC ID 1850712530, 57 clinicians

Practice addresses (Care Compare)

1846 N Broadway
Suite a
Santa Maria, CA 93454-1447
Phone (805) 361-4279

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58545CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Center CurrentSince Oct 21, 2019 Accepting new patients
Southwest Medical Center CurrentSince Oct 21, 2019 Accepting new patients
Cottage Medical Associates Past Accepting new patients

Locations

2130 N Kansas Ave
Liberal, KS 67901
Phone (316) 626-5060

315 W 15th St
Liberal, KS 67901
Phone (620) 624-1651

555 W 15th St
Liberal, KS 67901
Phone (620) 624-0702

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1265091946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3006 LOMITA RD",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931053320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3006 LOMITA RD",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931053320",
            "telephone_number": "805-636-1489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTLING",
        "first_name": "CHRISTOPHER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-06",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58545",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.