Polly Mudita Dursum, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95017866 Issued in CA

Practice address

1722 State St Ste 101
Santa Barbara, CA 93101-2526

Phone

(805) 969-9004

NPI assigned

Jan 3, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Montecito Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Santa Barbara, CA
  • NPI 1619428489
  NPD (past)

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

{
    "created_epoch": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1336800242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 CALLE ANZUELO",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931111721",
            "telephone_number": "818-404-9140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 STATE ST STE 101",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931012526",
            "telephone_number": "805-969-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURSUM",
        "first_name": "POLLY",
        "middle_name": "MUDITA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-03",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nivek Dunne
• Quang M Duong, PHARM D.
• Thomas C Duran III
• Maria Antonia Durbiano, M.A.
• Zia Inanna Durnin
• Ruth Ann Dussert, LE
• Shannon Dutter, PT
• Amanda Dutton, PA-C
• Kathleen W Duval, MA, LMFT
• Danielle Renee Dwan, MPH

• Family Nurse Practitioner in Santa Barbara, CA
• Providers in Santa Barbara, 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 Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.