Individual provider Active NPI

Lisa June Molin

  • Otolaryngology Physician
  • San Luis Obispo, CA
National Provider Identifier
1366447138
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A55137 Issued in CA
Practice address
1555 Higuera St
San Luis Obispo, CA 93401-2917
Phone
(805) 541-2368
Fax
(805) 541-2553
NPI assigned
Jun 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A55137 CA
Otolaryngology Physician 207Y00000X A55137 CA Primary

Addresses

Primary practice location

1555 Higuera St
San Luis Obispo, CA 93401-2917

Mailing address

901 Oak Park Blvd Ste 202
Pismo Beach, CA 93449-3410
Phone (805) 481-1368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101209000945 CA Practitioner - Otolaryngology 0244289346 Reassigns benefits to 1 organization
I20240520000043 TX Practitioner - Otolaryngology 0244289346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Iowa, RJ & L Carver College of Medicine, 1995
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)

1555 Higuera St
San Luis Obispo, CA 93401-2917
Phone (805) 541-3200

Hospital & facility affiliations

  • French Hospital Medical Center Hospital, San Luis Obispo, CA, CCN 050232
  • Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107
  • Samuel Simmonds Memorial Hospital Hospital, Barrow, AK, CCN 021312

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Central Coast Health Centers CurrentSince May 1, 2021 Accepting new patients
Pacific Central Coast Health Centers CurrentSince May 1, 2021 Accepting new patients
Arctic Slope Native Association LTD Current Accepting new patients
Pacific Central Coast Health Centers Current Accepting new patients
Dignity Community Care Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients
Dignity Health Past Accepting new patients
Dignity Health Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients

Locations

901 Oak Park Blvd
Ste 202
Pismo Beach, CA 93449
Phone (805) 316-1410

1510 E Main St
Ste 104C
Santa Maria, CA 93454
Phone (805) 349-8514

1414 E Main St
Ste 201
Santa Maria, CA 93454
Phone (805) 739-3112

117 W Bunny Ave
Santa Maria, CA 93458
Phone (805) 739-3474

895 Aerovista Pl
Ste 103
Sn Luis Obisp, CA 93401
Phone (805) 541-2368

1555 Higuera St
Sn Luis Obisp, CA 93401
Phone (805) 543-4043

Organizations & group practices 10

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1366447138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 OAK PARK BLVD STE 202",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493410",
            "telephone_number": "805-481-1368",
            "fax_number": "805-481-8013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 HIGUERA ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012917",
            "telephone_number": "805-541-2368",
            "fax_number": "805-541-2553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLIN",
        "first_name": "LISA",
        "middle_name": "JUNE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A55137",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A55137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.