NPIMap

Individual provider Active NPI

Kevin L Ferguson, M.D.

  • Clinical Pathology/Laboratory Medicine Physician
  • Santa Maria, CA
National Provider Identifier
1801823067
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
License
A71757 Issued in CA
Practice address
1400 E Church St
Santa Maria, CA 93454-5906
Phone
(805) 548-1550
NPI assigned
Jun 26, 2006
Last updated
Sep 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Pathology) Physician 207ZH0000X A71757 CA
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X A71757 CA Primary

Addresses

Primary practice location

1400 E Church St
Santa Maria, CA 93454-5906

Mailing address

PO Box 8139
San Luis Obispo, CA 93403-8139
Phone (805) 541-6033

Other identifiers 3

IdentifierTypeStateIssuer
00A717570MedicaidCA
GR0058760MedicaidCA
LAB43503FMedicaidCA

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
I20060124000870 CA Practitioner - Pathology 4284658642 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Washington University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic Pathology Services of the Central CoastGroup PAC ID 4284871658, 12 clinicians
Santa Maria Gastroenterology Medical Group Inc.Group PAC ID 6709070964, 23 clinicians

Practice addresses (Care Compare)

1400 E Church St
Santa Maria, CA 93454-5906
Phone (805) 739-3000

1515 E Ocean Ave
Lompoc, CA 93436-7092
Phone (805) 737-3300

361 Town Ctr W
Santa Maria, CA 93458-5076
Phone (805) 922-6581

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.04 of 100Reported as group
Quality
78.07
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.79 of 100Reported as group
Quality
74.86
Promoting interoperability
100
Improvement activities
40
Cost
73.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A71757CAMDHematology (Pathology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Pathology Services of the Central Coast CurrentSince Feb 4, 2013 Accepting new patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients
Twin Cities Community Hospital, Inc. Past Accepting new patients
Central Coast Pathology Consultants, Inc Past Accepting new patients
Dignity Health PastSince Jul 1, 2015 Accepting new patients
Dignity Health Past Accepting new patients
Central Coast Pathology Consultants, Inc. Past Accepting new patients
Dignity Community Care Past Accepting new patients

Locations

1400 E Church St
Santa Maria, CA 93454
Phone (805) 739-3000

1414 E Main St
Ste 102
Santa Maria, CA 93454
Phone (805) 548-1550

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1801823067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8139",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934038139",
            "telephone_number": "805-541-6033",
            "fax_number": "805-549-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E CHURCH ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545906",
            "telephone_number": "805-548-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "KEVIN",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "CA",
            "license": "A71757",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "CA",
            "license": "A71757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A717570",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0058760",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB43503F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.