NPIMap

Individual provider Active NPI

Mark Christopher Juretic, MD

  • Internal Medicine Physician
  • Santa Barbara, CA
National Provider Identifier
1689778029
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A51459 Issued in CA
Practice address
215 Pesetas LN
Santa Barbara, CA 93110-1416
Phone
(805) 681-7602
Fax
(805) 681-7632
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A51459 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) 681-7602

Other identifiers 2

IdentifierTypeStateIssuer
00A514590MedicaidCA
WA51459HOtherCAMEDICARE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100816000771 CA Practitioner - Internal Medicine 6608900402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Baylor College of Medicine, 1991
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)

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A51459CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sansum Clinic CurrentSince Mar 28, 2017 Accepting new patients
Sansum Clinic Current Accepting new patients
Sansum Clinic CurrentSince Mar 28, 2017 Accepting new patients
Dignity Health Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
Sansum Clinic Past Accepting new patients
Santa Barbara Cottage Hospital Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: mjuretic405355@hisp.ehr.sutterhealth.org

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1689778029",
    "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": "805-681-7602",
            "fax_number": "805-681-7632"
        },
        {
            "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": "805-681-7602",
            "fax_number": "805-681-7632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURETIC",
        "first_name": "MARK",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A51459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A514590",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "WA51459H",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.