Adalberto Medina Jr.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95030886 Issued in CA

Practice address

1102 E Clark Ave Ste 120a
Santa Maria, CA 93455-5175

Phone

(805) 332-8185

Fax

(805) 332-8186

NPI assigned

Jun 6, 2024

Last updated

Aug 4, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Central Coast Health CentersGroup PAC ID 9739091364, 247 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Pacific Central Coast Health Centers

  dba Marian Community Clinic

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

  dba Med Plus Orcutt

  • Community Health Clinic/Center
  • Santa Maria, CA
  • NPI 1306225941
  NPD
• Pacific Central Coast Health Centers

  dba Fair Oaks Specialty Center

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

  dba Monarch Village Health Center

  • Community Health Clinic/Center
  • Nipomo, CA
  • NPI 1417555061
  NPD (past)
• Pacific Central Coast Health Centers

  dba Dignity Health Women's Center - Southwest

  • 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 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": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1306687819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 E CLARK AVE STE 120A",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934555175",
            "telephone_number": "805-332-8185",
            "fax_number": "805-332-8186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 E CLARK AVE STE 120A",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934555175",
            "telephone_number": "805-332-8185",
            "fax_number": "805-332-8186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "877 Oak Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Pismo Beach",
            "state": "CA",
            "postal_code": "934493292",
            "country_code": "US",
            "telephone_number": "805-474-8450",
            "fax_number": "805-474-8454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "ADALBERTO",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-06",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95030886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MDG-Kitto Dental PC (Kitto Family Dental)
• Med World HME Inc
• Denys Alexandra Medel, LMFT
• Medical Support Los Angeles a Medical Corporation
• Esteban Medina Galvan
• Alexandra Medina
• Beatrice Medina
• Bismarck Medina
• Ezequiel Lazarus Medina
• Jessie Diane Paige Medina

• Family Nurse Practitioner in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.