Individual provider Active NPI

Melinda Jezierski, M.D.

  • Family Medicine Physician
  • Santa Maria, CA
National Provider Identifier
1487868154
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A120150 Issued in CA
Practice address
915 E Stowell Rd
Suite B
Santa Maria, CA 93454-7009
Phone
(805) 938-7444
NPI assigned
May 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A120150 CA Primary
Family Medicine Physician 207Q00000X M9381 TX

Addresses

Primary practice location

915 E Stowell Rd
Suite B
Santa Maria, CA 93454-7009

Mailing address

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

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
I20120516000585 CA Practitioner - Family Practice 2567528698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas a & M University System, HSC, College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Coast Family Care Medical Associates IncGroup PAC ID 7719967801, 9 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • Central Coast Home Health Inc Home health agency, San Luis Obispo, CA, CCN 059010
  • Dignity Health Home Health Home health agency, Santa Maria, CA, CCN 557038
  • Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107
  • French Hospital Medical Center Hospital, San Luis Obispo, CA, CCN 050232

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions86
Removal or shaving of skin growth30
Skin biopsy19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A120150CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Coast Family Care Medical Associates, Inc Family Medicine Current Accepting new patients
Central Coast Family Care Medical Associates, Inc. Family Medicine CurrentSince May 15, 2012 Accepting new patients
Central Coast Family Care Medical Associates, Inc Family Medicine CurrentSince May 15, 2012 Accepting new patients

Locations

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

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

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403136000000",
    "number": "1487868154",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEZIERSKI",
        "first_name": "MELINDA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2014-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A120150",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M9381",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.