Active NPI
Brian M Miyagishima, MD
- Family Medicine Physician
- Santa Maria, CA
National Provider Identifier
1801870662
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G69648
- Practice address
- 525 Plaza Dr
Suite 204a
Santa Maria, CA 93454-6953 - Phone
- (805) 925-3030
- Fax
- (805) 925-6453
- NPI assigned
- Dec 5, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G69648 | CA | Primary |
Addresses
Primary practice location
525 Plaza Dr
Suite 204a
Santa Maria, CA 93454-6953
Mailing address
504 Plaza Dr
Santa Maria, CA 93454-6917
Phone (805) 349-8514
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5781301 | Other | AETNA | |
| CB219047 | Other | CA | MEDICARE ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69648 | CA | MD | Pharmacist |
| G69648 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Central Coast Health Centers | Past | Accepting new patients | |
| Robert M Wood MD Inc | Family Medicine | Past | Accepting new patients |
| Pacific Central Coast Health Centers | Past | Accepting new patients |
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.
-
- Community Health Clinic/Center
- Santa Maria, CA
- NPI 1063496651
-
- Community Health Clinic/Center
- Bakersfield, CA
- NPI 1720752355
-
- Family Medicine Physician
- Santa Maria, CA
- NPI 1730227844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494288000000",
"number": "1801870662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 PLAZA DR",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "934546917",
"telephone_number": "805-349-8514",
"fax_number": "805-349-8958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 PLAZA DR",
"address_2": "SUITE 204A",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "934546953",
"telephone_number": "805-925-3030",
"fax_number": "805-925-6453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIYAGISHIMA",
"first_name": "BRIAN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-05",
"last_updated": "2017-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G69648",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5781301",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID",
"identifier": "CB219047",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Maria, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.