NPIMap

Individual provider Active NPI

John Phillip Okerblom, MD

  • Family Medicine Physician
  • Santa Maria, CA
National Provider Identifier
1427046945
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G42409 Issued in CA
Practice address
915 E Stowell Rd Ste B
Santa Maria, CA 93454-7010
Phone
(805) 938-7444
Fax
(805) 938-7422
NPI assigned
Oct 10, 2005
Last updated
Feb 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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 G42409 CA Primary

Addresses

Primary practice location

915 E Stowell Rd Ste B
Santa Maria, CA 93454-7010

Mailing address

915 E Stowell Rd
Suite B
Santa Maria, CA 93454-7009
Phone (805) 938-7444

Other identifiers 2

IdentifierTypeStateIssuer
00G424090OtherCABLUESHIELD PROVIDER #
00G424090MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100126000547 CA Practitioner - Family Practice 9133169873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Southern California Keck School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

915 E Stowell Rd B
Santa Maria, CA 93454-7010
Phone (805) 938-7444

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions94
Removal or shaving of skin growth1-10
Skin biopsy13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G42409CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Coast Family Care Medical Associates, Inc. Family Medicine CurrentSince Feb 1, 1998 Accepting new patients
Central Coast Family Care Medical Associates, Inc Family Medicine CurrentSince Feb 1, 1998 Accepting new patients
Central Coast Family Care Medical Associates, Inc Family Medicine Current Accepting new patients
Central Coast Family Care Medical Associates, Inc Family Medicine Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

355 Daniel Dr
Ste 105
Santa Maria, CA 93454
Phone (805) 937-3368

821 E Chapel St
Ste 203
Santa Maria, CA 93454
Phone (805) 354-5200

915 E Stowell Rd
Ste B
Santa Maria, CA 93454
Phone (805) 938-7424

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1427046945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 E STOWELL RD",
            "address_2": "SUITE B",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934547009",
            "telephone_number": "805-938-7444",
            "fax_number": "805-938-7422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 E STOWELL RD STE B",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934547010",
            "telephone_number": "805-938-7444",
            "fax_number": "805-938-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKERBLOM",
        "first_name": "JOHN",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G42409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD  PROVIDER  #",
            "identifier": "00G424090",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G424090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.