Individual provider Active NPI

Scarlett Okerblom-Sincoff, PA-C

  • Medical Physician Assistant
  • Santa Maria, CA
National Provider Identifier
1467804880
Registry record updated May 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA53779 Issued in CA
Practice address
220 S Palisade Dr Ste 104B
Santa Maria, CA 93454-5931
Phone
(805) 925-2521
Fax
(805) 925-8721
NPI assigned
Jul 9, 2016
Last updated
May 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA53779 CA Primary

Addresses

Primary practice location

220 S Palisade Dr Ste 104B
Santa Maria, CA 93454-5931

Mailing address

220 S Palisade Dr Ste 104B
Santa Maria, CA 93454-5931
Phone (805) 925-2521

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
I20161114001480 CA Practitioner - Physician Assistant 3072892108 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53779CAMDPediatric Dentist
PA53779CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central Coast Family Care Medical Associates, Inc. CurrentSince Oct 3, 2016 Accepting new patients
Central Coast Family Care Medical Associates, Inc CurrentSince Oct 3, 2016 Accepting new patients

Locations

220 S Palisade Dr
Ste 104B
Santa Maria, CA 93454
Phone (805) 925-2521

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1468022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714867200000",
    "number": "1467804880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 S PALISADE DR STE 104B",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545931",
            "telephone_number": "805-925-2521",
            "fax_number": "805-925-8721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S PALISADE DR STE 104B",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545931",
            "telephone_number": "805-925-2521",
            "fax_number": "805-925-8721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKERBLOM-SINCOFF",
        "first_name": "SCARLETT",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-09",
        "last_updated": "2024-05-05",
        "certification_date": "2024-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA53779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.