Individual provider Active NPI

Marilyn Mendoza, M.D.

  • Pediatrics Physician
  • Santa Barbara, CA
National Provider Identifier
1427492156
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A133701 Issued in CA
Practice address
51 Hitchcock Way
Santa Barbara, CA 93105
Phone
(805) 563-6211
NPI assigned
Apr 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A133701 CA Primary

Addresses

Primary practice location

51 Hitchcock Way
Santa Barbara, CA 93105

Mailing address

PO Box 62106
Santa Barbara, CA 93160-2106
Phone (805) 563-6211

Other practice location 1

505 S Main St
Orange, CA 92868-4509
Phone (805) 705-2380

Other practice location 2

505 S Main St
Orange, CA 92868-4509
Phone (805) 705-2380

Other identifiers 1

IdentifierTypeStateIssuer
A133701OtherCAMEDICAL LICENSE

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
I20161205002421 CA Practitioner - Pediatric Medicine 3779891742 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
133701CAMDMarriage & Family Therapist
A133701CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sansum Clinic CurrentSince Nov 14, 2016 Accepting new patients
Sansum Clinic CurrentSince Nov 14, 2016 Accepting new patients
Sansum Clinic Current Accepting new patients
Sansum Clinic Past Accepting new patients
Santa Barbara Cottage Hospital Past Accepting new patients
Goleta Valley Cottage Hospital Past Accepting new patients

Locations

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

51 Hitchcock Way
Santa Barbara, CA 93105
Phone (805) 563-6100

Interoperability endpoints

  • Direct secure messaging: mmendoza760646@hisp.ehr.sutterhealth.org

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1427492156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62106",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931602106",
            "telephone_number": "805-563-6211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 HITCHCOCK WAY",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "93105",
            "telephone_number": "805-563-6211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 S Main St",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928684509",
            "country_code": "US",
            "telephone_number": "805-705-2380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "505 S Main St",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928684509",
            "country_code": "US",
            "telephone_number": "805-705-2380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "MARILYN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-24",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A133701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A133701",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.