Individual provider Active NPI

Maria G Sciammarella, M.D.

  • Specialist
  • San Luis Obispo, CA
National Provider Identifier
1689756256
Registry record updated Sep 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A72324 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
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A72324 CA Primary
Cardiovascular Disease Physician 207RC0000X A72324 CA
Interventional Cardiology Physician 207RI0011X A72324 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 identifiers 2

IdentifierTypeStateIssuer
GR0068680MedicaidCA
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
I20040617001757 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4587648241 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of California SFGH Medical GroupGroup PAC ID 5496668410, 566 clinicians

Practice addresses (Care Compare)

1001 Potrero Ave
San Francisco, CA 94110-3518
Phone (628) 206-3503

Hospital & facility affiliations

  • Zuckerberg San Francisco General Hosp & Trauma Ctr Hospital, San Francisco, CA, CCN 050228

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of California SFGH Medical Group Cardiovascular Disease CurrentSince Aug 16, 2009 Accepting new patients
City and County of San Francisco CurrentSince Nov 10, 2019 Accepting new patients
City & County of San Francisco CurrentSince Nov 10, 2019 Accepting new patients
City & County of San Francisco Current Accepting new patients
University of California SFGH Medical Group CurrentSince Aug 16, 2009 Accepting new patients

Locations

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

1001 Potrero Ave
Rm 5G1
San Francisco, CA 94110
Phone (628) 206-3503

Organizations & group practices 5

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 2

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190851200000",
    "number": "1689756256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 JOHNSON AVE 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 STE 101",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014154",
            "telephone_number": "805-782-8844",
            "fax_number": "805-782-8859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCIAMMARELLA",
        "first_name": "MARIA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A72324",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A72324",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A72324",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0068680",
            "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.