Individual provider Active NPI

Mark J Sada, MD, FACC

  • Interventional Cardiology Physician
  • San Luis Obispo, CA
National Provider Identifier
1639157282
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
G69997 Issued in CA
Practice address
1941 Johnson Ave
Ste 101
San Luis Obispo, CA 93401-4154
Phone
(805) 782-8844
Fax
(805) 782-8859
NPI assigned
Jan 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X G69997 CA Primary
Cardiovascular Disease Physician 207RC0000X G69997 CA

Addresses

Primary practice location

1941 Johnson Ave
Ste 101
San Luis Obispo, CA 93401-4154

Mailing address

1941 Johnson Ave
Ste 101
San Luis Obispo, CA 93401-4154
Phone (805) 782-8844

Other practice location 1

850 Fair Oaks Ave Ste 100
Arroyo Grande, CA 93420-3929
Phone (805) 782-8844

Other practice location 2

1941 Johnson Ave Ste 102
San Luis Obispo, CA 93401-4174
Phone (805) 782-8844

Other practice location 3

295 Posada Ln Ste A
Templeton, CA 93465-4055
Phone (805) 782-8844

Other identifiers 3

IdentifierTypeStateIssuer
00G699970MedicaidCA
990003291OtherCARR MEDI-CARE
ZZZ28458ZOtherCABLUE SHIELD

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
I20040830000935 CA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 6204801558 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Stanford University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Central Coast Health CentersGroup PAC ID 9739091364, 247 clinicians

Practice addresses (Care Compare)

1941 Johnson Ave
Suite 101
San Luis Obispo, CA 93401-4154
Phone (805) 782-8844

Hospital & facility affiliations

  • French Hospital Medical Center Hospital, San Luis Obispo, CA, CCN 050232
  • Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107
  • Adventist Health Twin Cities Hospital, Templeton, CA, CCN 050633
  • Adventist Health Sierra Vista Hospital, San Luis Obispo, CA, CCN 050506

Merit-based Incentive Payment System (MIPS)

Final score
84.07 of 100Reported as group
Quality
80.14
Promoting interoperability
94
Improvement activities
40
Cost
71.76

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

ProcedureNumber of procedures
Coronary angioplasty and stenting19
Pacemaker insertion or repair55
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69997CAMDClinical Social Worker
G69997CAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Central Coast Health Centers CurrentSince Nov 8, 2024 Accepting new patients
Coastal Cardiology a Medical Corp Cardiovascular Disease Current Accepting new patients
Pacific Central Coast Health Centers CurrentSince Nov 8, 2024 Accepting new patients
Coastal Cardiology a Medical Corp Cardiovascular Disease Current Accepting new patients
Coastal Cardiology a Medical Corp Cardiovascular Disease Current Accepting new patients
Pacific Central Coast Health Centers Current Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients

Locations

850 Fair Oaks Ave
Ste 100
Arroyo Grande, CA 93420
Phone (805) 473-0700

345 S Halcyon Rd
Arroyo Grande, CA 93420
Phone (805) 489-4261

310 S Halcyon Rd
Ste 105
Arroyo Grande, CA 93420
Phone (805) 481-8233

1941 Johnson Ave
Ste 102
San Luis Obispo, CA 93401
Phone 8057828844 ext. 161

1414 E Main St
Ste 201
Santa Maria, CA 93454
Phone (805) 739-3112

117 W Bunny Ave
Santa Maria, CA 93458
Phone (805) 739-3474

1510 E Main St
Ste 104C
Santa Maria, CA 93454
Phone (805) 349-8514

1911 Johnson Ave
Sn Luis Obisp, CA 93401
Phone (805) 542-6633

1941 Johnson Ave
Ste 101
Sn Luis Obisp, CA 93401

1010 Murray Ave
Sn Luis Obisp, CA 93405
Phone (805) 546-7600

1100 Las Tablas Rd
Templeton, CA 93465
Phone (805) 434-3500

295 Posada Ln
Ste A
Templeton, CA 93465
Phone (805) 434-2262

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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 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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1639157282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 JOHNSON AVE",
            "address_2": "STE 101",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014154",
            "telephone_number": "805-782-8844",
            "fax_number": "805-782-8859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 JOHNSON AVE",
            "address_2": "STE 101",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014154",
            "telephone_number": "805-782-8844",
            "fax_number": "805-782-8859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 Fair Oaks Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Arroyo Grande",
            "state": "CA",
            "postal_code": "934203929",
            "country_code": "US",
            "telephone_number": "805-782-8844",
            "fax_number": "805-549-6988",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1941 Johnson Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "San Luis Obispo",
            "state": "CA",
            "postal_code": "934014174",
            "country_code": "US",
            "telephone_number": "805-782-8844",
            "fax_number": "805-549-6986",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "295 Posada Ln Ste A",
            "address_purpose": "LOCATION",
            "city": "Templeton",
            "state": "CA",
            "postal_code": "934654055",
            "country_code": "US",
            "telephone_number": "805-782-8844",
            "fax_number": "805-549-6987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SADA",
        "first_name": "MARK",
        "middle_name": "J",
        "credential": "MD, FACC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "G69997",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G69997",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G699970",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDI-CARE",
            "identifier": "990003291",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ28458Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.