Individual provider Active NPI

Angelina Dukesherer, MD

  • Internal Medicine Physician
  • Santa Barbara, CA
National Provider Identifier
1295987899
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A113315 Issued in CA
Practice address
320 W Pueblo St
Santa Barbara, CA 93105-4311
Phone
(805) 464-6104
Fax
(805) 733-1213
NPI assigned
Oct 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A113315 CA Primary

Addresses

Primary practice location

320 W Pueblo St
Santa Barbara, CA 93105-4311

Mailing address

836 Anacapa St # 20058
Santa Barbara, CA 93102-9997
Phone (805) 464-6104

Other names 1

  • Angelina Tan Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111020000693 CA Practitioner - Internal Medicine 1052583820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

320 W Pueblo St
Santa Barbara, CA 93105-4311
Phone (805) 464-6104

Hospital & facility affiliations

  • Santa Barbara Cottage Hospital Hospital, Santa Barbara, CA, CCN 050396
  • Goleta Valley Cottage Hospital Hospital, Santa Barbara, CA, CCN 050357
  • Santa Ynez Valley Cottage Hospital Hospital, Solvang, CA, CCN 051331

Merit-based Incentive Payment System (MIPS)

Final score
69.59 of 100Reported as individual
Quality
100
Improvement activities
0
Cost
85.3

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A113315CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dukesherer Medical Corporation Internal Medicine CurrentSince Mar 1, 2022 Accepting new patients

Locations

320 W Pueblo St
Santa Barbara, CA 93105
Phone (805) 464-6104

Organizations & group practices 1

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 3

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": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1295987899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 ANACAPA ST # 20058",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931029997",
            "telephone_number": "805-464-6104",
            "fax_number": "805-733-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W PUEBLO ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931054311",
            "telephone_number": "805-464-6104",
            "fax_number": "805-733-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUKESHERER",
        "first_name": "ANGELINA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-15",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A113315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELINA",
            "last_name": "TAN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.