Individual provider Active NPI

Manuel Aaron Garmendia, PA-C

  • Physician Assistant
  • San Luis Obispo, CA
National Provider Identifier
1437624103
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA57579 Issued in CA
Practice address
225 Prado Rd Ste D
San Luis Obispo, CA 93401
Phone
(805) 786-2500
NPI assigned
Oct 9, 2018
Last updated
Feb 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA57579 CA Primary

Addresses

Primary practice location

225 Prado Rd Ste D
San Luis Obispo, CA 93401

Mailing address

225 Prado Rd Ste D
San Luis Obispo, CA 93401-7363
Phone (805) 786-2500

Other practice location 1

2575 Yorba Linda Blvd
Fullerton, CA 92831-1615
Phone (619) 944-2551

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200311001252 CA Practitioner - Physician Assistant 0345678033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
JC Edwards School of Medicine, Marshall University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1111 E Ocean Ave
Suite 3
Lompoc, CA 93436-2500
Phone (805) 733-8150

116 S Palisade Dr
Suite 110
Santa Maria, CA 93454-8905
Phone (805) 349-7133

225 Prado Rd
Suite D
San Luis Obispo, CA 93401-7363

921 Oak Park Blvd
Suite 202
Pismo Beach, CA 93449-3400
Phone (805) 473-7818

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
57579CAMDPharmacotherapy Pharmacist
PA57579CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Associates of the Central Coast CurrentSince Jan 27, 2020 Accepting new patients

Locations

921 Oak Park Blvd
Ste 202
Pismo Beach, CA 93449
Phone (805) 473-7818

116 S Palisade Dr
Ste 110
Santa Maria, CA 93454
Phone (805) 349-7133

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/9c3d5f6c-4d59-4a7f-9170-c96c3d9e561c/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1437624103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 PRADO RD STE D",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017363",
            "telephone_number": "805-786-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 PRADO RD STE D",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93401",
            "telephone_number": "805-786-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2575 Yorba Linda Blvd",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928311615",
            "country_code": "US",
            "telephone_number": "619-944-2551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARMENDIA",
        "first_name": "MANUEL",
        "middle_name": "AARON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-09",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA57579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.