Individual provider Active NPI

Sam Safaee, PA-C

  • Physician Assistant
  • Santa Maria, CA
National Provider Identifier
1609172030
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21412 Issued in CA
Practice address
201 S Miller St Ste 103
Santa Maria, CA 93454-5248
Phone
(805) 314-2175
Fax
(805) 314-2219
NPI assigned
Feb 2, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA21412 CA
Physician Assistant 363A00000X PA21412 CA Primary

Addresses

Primary practice location

201 S Miller St Ste 103
Santa Maria, CA 93454-5248

Mailing address

201 S Miller St Ste 103
Santa Maria, CA 93454-5248
Phone (805) 314-2175

Other practice location 1

5750 Traffic Way
Atascadero, CA 93422-7204
Phone (855) 378-3361

Other identifiers 2

IdentifierTypeStateIssuer
12317742OtherCACAQH PROVIDER NUMBER
PA21412OtherCAPHYSICIAN ASSISTANT COMMITTEE LICENSE

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
I20110622000021 CA Practitioner - Physician Assistant 1951589944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chris E Esguerra MD PCGroup PAC ID 8426456021, 10 clinicians

Practice addresses (Care Compare)

5750 Traffic Way
Suite a
Atascadero, CA 93422-7205
Phone (855) 378-3361

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21412CAMDGeneral Practice Dentistry
PA21412CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Regenerative Spine, Pain, and Neuropathy Centers, Inc. PastSince Jun 22, 2021 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1296604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1609172030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S MILLER ST STE 103",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545248",
            "telephone_number": "805-314-2175",
            "fax_number": "805-314-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S MILLER ST STE 103",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545248",
            "telephone_number": "805-314-2175",
            "fax_number": "805-314-2219"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5750 Traffic Way",
            "address_purpose": "LOCATION",
            "city": "Atascadero",
            "state": "CA",
            "postal_code": "934227204",
            "country_code": "US",
            "telephone_number": "855-378-3361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAFAEE",
        "first_name": "SAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-02",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA21412",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER NUMBER",
            "identifier": "12317742",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT COMMITTEE LICENSE",
            "identifier": "PA21412",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.