Individual provider Active NPI

Michael S McConnell

  • Psychiatric/Mental Health Nurse Practitioner
  • Santa Maria, CA
National Provider Identifier
1356693683
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
21104 Issued in CA
Practice address
500 W Foster Rd
Santa Maria, CA 93455-3620
Phone
(805) 934-6380
Fax
(805) 934-6600
NPI assigned
Oct 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 21104 CA Primary

Addresses

Primary practice location

500 W Foster Rd
Santa Maria, CA 93455-3620

Mailing address

500 W Foster Rd
Santa Maria, CA 93455-3620
Phone (805) 934-6380

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140605001185 CA Practitioner - Nurse Practitioner 7214151687 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Santa Barbara County AuditorGroup PAC ID 9335052083, 98 clinicians

Practice addresses (Care Compare)

4444 Calle Real
Santa Barbara, CA 93110-1002
Phone (805) 681-5190

Hospital & facility affiliations

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Barbara County Auditor CurrentSince Oct 20, 2020 Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince Feb 19, 2014 Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince Feb 19, 2014 Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Santa Barbara County County Auditor CurrentSince Oct 20, 2020 Accepting new patients

Locations

4723 W Main St
Ste H
Guadalupe, CA 93434
Phone (805) 343-2004

429 N San Antonio Rd
Santa Barbara, CA 93110
Phone (805) 884-1600

4444 Calle Real
Santa Barbara, CA 93110
Phone (805) 681-5190

2050 S Blosser Rd
Santa Maria, CA 93458
Phone (805) 361-8014

2801 Santa Maria Way
Bldg B
Santa Maria, CA 93455
Phone (805) 938-9200

500 W Foster Rd
Santa Maria, CA 93455
Phone (805) 934-6380

2801 Santa Maria Way
Bldg A
Santa Maria, CA 93455
Phone (805) 938-9200

1551 Bishop St
Ste A160
Sn Luis Obisp, CA 93401
Phone (805) 781-4230

325 Posada Ln
Templeton, CA 93465
Phone (805) 239-0644

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1356693683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W FOSTER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934553620",
            "telephone_number": "805-934-6380",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W FOSTER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934553620",
            "telephone_number": "805-934-6380",
            "fax_number": "805-934-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-10",
        "last_updated": "2023-06-14",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "21104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.