Blanca Bisuna, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A125110 Issued in CA

Practice address

1250 Peach Street
Suite a
San Luis Obispo, CA 93401-2837

Phone

(805) 543-4043

Fax

(805) 543-7640

NPI assigned

Sep 10, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Family Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD (past)
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• Providence Medical Foundation

  • Hematology & Oncology Physician
  • Orange, CA
  • NPI 1801443510
  NPD
• Doctors Medical Center of Modesto, Inc.

  dba Doctors Medical Center of Modesto

  • General Acute Care Hospital
  • Modesto, CA
  • NPI 1184654923
  NPD (past)
• Mission Hospital Regional Medical Center

  dba Providence Mission Hospital

  • Rehabilitation Hospital
  • Mission Viejo, CA
  • NPI 1003956913
  NPD (past)
• Pacific Central Coast Health Centers

  dba Dignity Health Women's Center - Southwest

  • Community Health Clinic/Center
  • Bakersfield, CA
  • NPI 1720752355
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mission Hospital Regional Medical Center

  dba Providence Mission Hospital

  • General Acute Care Hospital
  • Mission Viejo, CA
  • NPI 1912108002
  Care Compare affiliation
• Mission Hospital Regional Medical Center

  dba Mission Hospital

  • General Acute Care Hospital
  • Mission Viejo, CA
  • NPI 1992752315
  Care Compare affiliation

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

{
    "created_epoch": "1252540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1508199431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 WEST BUNNY AVENUE",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934582805",
            "telephone_number": "805-543-4043",
            "fax_number": "805-543-7640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 PEACH STREET",
            "address_2": "SUITE A",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012837",
            "telephone_number": "805-543-4043",
            "fax_number": "805-543-7640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISUNA",
        "first_name": "BLANCA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-10",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A125110",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A125110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "CB234677",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbisuna1373895@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "26732 Crown Valley Pkwy Ste 170",
            "city": "Mission Viejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926916337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeffrey John Bisely, DDS
• Ahna Nicole Bishop, LCSW
• Mark Douglas Bishop
• Megan M Bishop, B.S., NUTRITIONIST
• Shante L Bishop
• Mollie Chainani Bivens, MOT, OTR/L
• Michaela Bixler, R.D.H.
• Emily Blair
• Hayley Blakemore
• Trina Blanchette

• Family Medicine Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.