Individual provider Active NPI

Peter C Fillerup

  • Foot & Ankle Surgery Podiatrist
  • Santa Maria, CA
National Provider Identifier
1366450405
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E3665 Issued in CA
Practice address
1145 E Clark Ave Ste a
Santa Maria, CA 93455-5150
Phone
(805) 934-0570
Fax
(805) 938-7688
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E3665 CA Primary

Addresses

Primary practice location

1145 E Clark Ave Ste a
Santa Maria, CA 93455-5150

Mailing address

1145 E Clark Ave Ste a
Santa Maria, CA 93455-5150
Phone (805) 934-0570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120224000732 CA Practitioner - Podiatry 2769594522 Practice locations: Santa Maria, CA
O20100930083528 CA DME Supplier - Physician - Podiatry 5496867251 Practice locations: Santa Maria, CA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1145 E Clark Ave
Suite a
Santa Maria, CA 93455-5150
Phone (805) 934-0570

Hospital & facility affiliations

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

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue116
Removal of skin lesions34
Removal of nail tissue182
Removal or shaving of skin growth284
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
3665CAMDProfessional Counselor
E3665CAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lompoc Valley Medical Center Past Accepting new patients
Dignity Health Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1366450405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 E CLARK AVE STE A",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934555150",
            "telephone_number": "805-934-0570",
            "fax_number": "805-938-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 E CLARK AVE STE A",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934555150",
            "telephone_number": "805-934-0570",
            "fax_number": "805-938-7688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILLERUP",
        "first_name": "PETER",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E3665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.