Individual provider Active NPI

Bailey Mena, PA-C

  • Physician Assistant
  • San Luis Obispo, CA
National Provider Identifier
1598455636
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA62528 Issued in CA
Practice address
862 Meinecke Ave Ste 100
San Luis Obispo, CA 93405-3701
Phone
(805) 541-4600
NPI assigned
May 11, 2023
Last updated
May 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2023

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 PA62528 CA Primary

Addresses

Primary practice location

862 Meinecke Ave Ste 100
San Luis Obispo, CA 93405-3701

Mailing address

1731 E Feemster CT
Visalia, CA 93292-5149
Phone (559) 623-2022

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
I20230622001764 CA Practitioner - Physician Assistant 1951769082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David B. HammerGroup PAC ID 3971559881, 117 clinicians
Central Coast Orthopedic Medical GroupGroup PAC ID 8426945916, 19 clinicians

Practice addresses (Care Compare)

1051 Las Tablas Rd
Templeton, CA 93465-5603

862 Meinecke Ave
Suite 100
San Luis Obispo, CA 93405-3701
Phone (805) 541-4600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA62528CAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: bmena@centralcoastortho.emadirect.md

Organizations & group practices 1

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 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": "1683763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1598455636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 E FEEMSTER CT",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932925149",
            "telephone_number": "559-623-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "862 MEINECKE AVE STE 100",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934053701",
            "telephone_number": "805-541-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENA",
        "first_name": "BAILEY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-11",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA62528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.