Individual provider Active NPI

Madeline Carlene Perez-Andrade, PA

  • Physician Assistant
  • Santa Barbara, CA
National Provider Identifier
1639841869
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60755 Issued in CA
Practice address
215 Pesetas LN
Santa Barbara, CA 93110-1416
Phone
(805) 681-7500
NPI assigned
Oct 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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 PA60755 CA Primary

Addresses

Primary practice location

215 Pesetas LN
Santa Barbara, CA 93110-1416

Mailing address

PO Box 62106
Santa Barbara, CA 93160-2106
Phone (805) 681-1760

Other names 1

  • Madeline Carlene Perez Former name

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
I20220715002127 CA Practitioner - Physician Assistant 0345621728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sansum ClinicGroup PAC ID 3678471976, 320 clinicians

Practice addresses (Care Compare)

2040 Viborg Rd
Suite 140
Solvang, CA 93463-2272
Phone (805) 681-1761

215 Pesetas LN
Santa Barbara, CA 93110-1416
Phone (805) 681-7800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA60755CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sansum Clinic CurrentSince May 2, 2022 Accepting new patients
Santa Barbara Cottage Hospital Past Accepting new patients

Locations

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

Interoperability endpoints

  • Direct secure messaging: mperezandrade760688@hisp.ehr.sutterhealth.org

Organizations & group practices 3

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": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1639841869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62106",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931602106",
            "telephone_number": "805-681-1760",
            "fax_number": "805-681-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 PESETAS LN",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931101416",
            "telephone_number": "805-681-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ-ANDRADE",
        "first_name": "MADELINE",
        "middle_name": "CARLENE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-05",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA60755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADELINE",
            "last_name": "PEREZ",
            "middle_name": "CARLENE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.