Individual provider Active NPI

Miriam Elizade Lomelino, MD

  • Family Medicine Physician
  • Templeton, CA
National Provider Identifier
1619952538
Registry record updated May 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A72626 Issued in CA
Practice address
1320 Las Tablas Rd
Suite F
Templeton, CA 93465-9711
Phone
(805) 434-0025
Fax
(805) 434-0029
NPI assigned
Dec 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A72626 CA Primary

Addresses

Primary practice location

1320 Las Tablas Rd
Suite F
Templeton, CA 93465-9711

Mailing address

1320 Las Tablas Rd
Suite F
Templeton, CA 93465-9711
Phone (805) 434-0025

Other identifiers 3

IdentifierTypeStateIssuer
00A726260OtherCAAETNA PIN
00A726260MedicaidCA
00A726260OtherCABLUE SHIELD PIN

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
I20100216000481 CA Practitioner - Family Practice 1052455961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Irvine, California College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
David B. HammerGroup PAC ID 3971559881, 117 clinicians
Lomelino Medical Group PCGroup PAC ID 3274718085, 5 clinicians

Practice addresses (Care Compare)

1051 Las Tablas Rd
Templeton, CA 93465-5603

1320 Las Tablas Rd
Suite F
Templeton, CA 93465-9711
Phone (805) 434-0025

Hospital & facility affiliations

  • French Hospital Medical Center Hospital, San Luis Obispo, CA, CCN 050232
  • Adventist Health Twin Cities Hospital, Templeton, CA, CCN 050633
  • Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107

Merit-based Incentive Payment System (MIPS)

Final score
85.59 of 100Reported as individual
Quality
87.47
Improvement activities
40
Cost
68.68

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A72626CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lomelino Medical Group PC Family Medicine CurrentSince Apr 1, 2011 Accepting new patients

Locations

1320 Las Tablas Rd
Ste F
Templeton, CA 93465
Phone (805) 434-0025

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304553600000",
    "number": "1619952538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 LAS TABLAS RD",
            "address_2": "SUITE F",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934659711",
            "telephone_number": "805-434-0025",
            "fax_number": "805-434-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 LAS TABLAS RD",
            "address_2": "SUITE F",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934659711",
            "telephone_number": "805-434-0025",
            "fax_number": "805-434-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOMELINO",
        "first_name": "MIRIAM",
        "middle_name": "ELIZADE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2011-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A72626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "00A726260",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A726260",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN",
            "identifier": "00A726260",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Templeton, CA

Sources for this page

Verify at the official NPI Registry.