Jeffrey B Mundorf, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

A50612 Issued in CA

Practice address

1551 Bishop St Ste 230
San Luis Obispo, CA 93401-4661

Phone

(805) 434-5530

Fax

(805) 434-0023

NPI assigned

Nov 9, 2005

Last updated

Oct 2, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Gastroenterology

Education

University of Texas Southwestern Medical School at Dallas, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pacific Central Coast Health CentersGroup PAC ID 9739091364, 247 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• French Hospital Medical Center Hospital, San Luis Obispo, CA, CCN 050232
• Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107

Merit-based Incentive Payment System (MIPS)

Final score

99.64 of 100Reported as apm

Quality

86.27

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

• Pacific Central Coast Health Centers

  dba Marian Community Clinic

  • Community Health Clinic/Center
  • Santa Maria, CA
  • NPI 1063496651
  Medicare reassignment Care Compare group NPD
• Pacific Central Coast Health Centers

  dba Family Medicine Center

  • Community Health Clinic/Center
  • Santa Maria, CA
  • NPI 1760723910
  NPD
• Pacific Central Coast Health Centers

  dba Fair Oaks Specialty Center

  • Community Health Clinic/Center
  • Arroyo Grande, CA
  • NPI 1831764117
  NPD
• Charles L. Fulbeck, M.D., Inc

  dba Charles L. Fulbeck, M.D.

  • Gastroenterology Physician
  • San Luis Obispo, CA
  • NPI 1558443440
  NPD (past)
• Dignity Community Care

  dba French Hospital Medical Center

  • General Acute Care Hospital
  • San Luis Obispo, CA
  • NPI 1881760452
  NPD (past)
• Dignity Health

  • General Acute Care Hospital
  • Santa Maria, CA
  • NPI 1760510937
  NPD (past)
• Dignity Health

  dba Arroyo Grande Community Hospital

  • General Acute Care Hospital
  • Arroyo Grande, CA
  • NPI 1770659336
  NPD (past)
• Doctors Medical Center of Modesto, Inc.

  dba Doctors Medical Center of Modesto

  • General Acute Care Hospital
  • Modesto, CA
  • NPI 1184654923
  NPD (past)
• Pacific Central Coast Health Centers

  dba Dignity Health Women's Center - Southwest

  • Community Health Clinic/Center
  • Bakersfield, CA
  • NPI 1720752355
  NPD (past)
• Pacific Central Coast Health Centers

  dba Medical Clinic at Morro

  • Community Health Clinic/Center
  • Morro Bay, CA
  • NPI 1821487414
  NPD (past)
• Twin Cities Community Hospital, Inc.

  dba Twin Cities Community Hospital

  • General Acute Care Hospital
  • Templeton, CA
  • NPI 1396778197
  NPD (past)

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

• Dignity Community Care

  dba French Hospital Medical Center

  • General Acute Care Hospital
  • San Luis Obispo, CA
  • NPI 1881760452
  Care Compare affiliation
• Dignity Health

  • General Acute Care Hospital
  • Santa Maria, CA
  • NPI 1760510937
  Care Compare affiliation

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1598746174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 BISHOP ST STE 230",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014661",
            "telephone_number": "805-434-5530",
            "fax_number": "805-434-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 BISHOP ST STE 230",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014661",
            "telephone_number": "805-434-5530",
            "fax_number": "805-434-0023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 Fair Oaks Ave Ste 220",
            "address_purpose": "LOCATION",
            "city": "Arroyo Grande",
            "state": "CA",
            "postal_code": "934203929",
            "country_code": "US",
            "telephone_number": "805-434-5530",
            "fax_number": "805-786-4220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Posada Ln Ste 202",
            "address_purpose": "LOCATION",
            "city": "Templeton",
            "state": "CA",
            "postal_code": "934654060",
            "country_code": "US",
            "telephone_number": "805-434-5497",
            "fax_number": "805-434-0917",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1325 E Church St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934545915",
            "country_code": "US",
            "telephone_number": "805-346-3456",
            "fax_number": "805-346-3454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNDORF",
        "first_name": "JEFFREY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A50612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccgastro@directaddress.net",
            "affiliation": "Y",
            "affiliationName": "Central Coast Gastroenterology Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1255 Las Tablas Rd",
            "address_2": "201",
            "city": "Templeton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "934659750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachelle Marie Mueller, N.P.
• Victoria Mulhall, ACSW
• Emily Mulhern
• Christine Stoffel Mulkerin, M.D.
• Heather Deanne Mullin, CMT, CST
• Lori Munyon
• Megan Murchison
• Alexandra Murdy
• Devin V Murguia
• Sofia Z Murillo

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.