Individual provider Active NPI

Victor Ismael Pulido, D.O.

  • Family Medicine Physician
  • Santa Maria, CA
National Provider Identifier
1407894652
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A5737 Issued in CA
Practice address
235 S Palisade Dr
Santa Maria, CA 93454
Phone
(805) 739-3561
NPI assigned
Jun 2, 2006
Sex
Male
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A5737 CA Primary

Addresses

Primary practice location

235 S Palisade Dr
Santa Maria, CA 93454

Mailing address

235 S Palisade Dr
Santa Maria, CA 93454-5948
Phone (805) 739-3561

Other practice location 1

220 S Palisade Dr Ste 203
Santa Maria, CA 93454-8903
Phone (805) 354-7101

Other identifiers 7

IdentifierTypeStateIssuer
95-1683892OtherCAOTHER INSURANCE
RHM08609FMedicaidCA
RHM18553HMedicaidCA
050394OtherCABLUE CROSS
ZZT40394FMedicaidCA
RHM08608FMedicaidCA
1215903018OtherCANPI

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050810001127 CA Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 0749219616 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
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)

1510 E Main St
Suite 104 C
Santa Maria, CA 93454-4825
Phone (805) 349-8514

Hospital & facility affiliations

  • Dignity Health Home Health Home health agency, Santa Maria, CA, CCN 557038
  • Central Coast Home Health Inc Home health agency, San Luis Obispo, CA, CCN 059010
  • Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107

Merit-based Incentive Payment System (MIPS)

Final score
50.33 of 100Reported as group
Quality
29.5
Improvement activities
0
Cost
80.36

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5737CAMDVision Therapy Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Central Coast Health Centers CurrentSince Aug 21, 2017 Accepting new patients
Pacific Central Coast Health Centers Current Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
Community Memorial Health System Past Accepting new patients
Community Memorial Health System Past Accepting new patients
Windsor Family Practice Family Medicine PastSince Feb 1, 2022 Accepting new patients

Locations

345 S Halcyon Rd
Arroyo Grande, CA 93420
Phone (805) 489-4261

1400 E Church St
Santa Maria, CA 93454
Phone (805) 739-3000

1400 E Church St
Bldg B
Santa Maria, CA 93454

235 S Palisade Dr
Santa Maria, CA 93454
Phone (805) 739-3561

220 S Palisade Dr
Ste 203
Santa Maria, CA 93454
Phone (805) 354-7101

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

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

1400 E Church St
Ofc
Santa Maria, CA 93454
Phone (805) 739-3112

Organizations & group practices 8

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1407894652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 S PALISADE DR",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545948",
            "telephone_number": "805-739-3561",
            "fax_number": "805-739-3560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 S PALISADE DR",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "93454",
            "telephone_number": "805-739-3561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 S Palisade Dr Ste 203",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934548903",
            "country_code": "US",
            "telephone_number": "805-354-7101",
            "fax_number": "805-354-7102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PULIDO",
        "first_name": "VICTOR",
        "middle_name": "ISMAEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A5737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER INSURANCE",
            "identifier": "95-1683892",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM08609F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM18553H",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "050394",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT40394F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM08608F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1215903018",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.