Individual provider Active NPI

Kevin Rodriguez Amenero, MD

  • Surgery Physician
  • Santa Maria, CA
National Provider Identifier
1811457625
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A196008 Issued in CA
Practice address
316 S Stratford Ave Ste B
Santa Maria, CA 93454-5908
Phone
(805) 332-8446
Fax
(805) 332-8483
NPI assigned
Mar 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A196008 CA Primary

Addresses

Primary practice location

316 S Stratford Ave Ste B
Santa Maria, CA 93454-5908

Mailing address

316 S Stratford Ave Ste B
Santa Maria, CA 93454-5908
Phone (805) 332-8446

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
I20240807003574 CA Practitioner - General Surgery 1355671199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Utah School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

316 S Stratford Ave
Suite B
Santa Maria, CA 93454-5908
Phone (805) 332-8446

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A196008CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Central Coast Health Centers CurrentSince Aug 26, 2024 Accepting new patients
Pacific Central Coast Health Centers CurrentSince Aug 26, 2024 Accepting new patients
Pacific Central Coast Health Centers Surgery Current Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients

Locations

500 Old River Rd
Ste 200
Bakersfield, CA 93311
Phone (661) 663-6429

2901 N Ventura Rd
Ste 110
Oxnard, CA 93036
Phone (805) 981-6163

1510 E Main St
Ste 104C
Santa Maria, CA 93454
Phone (805) 349-8514

1414 E Main St
Ste 201
Santa Maria, CA 93454
Phone (805) 739-3112

316 S Stratford Ave
Ste B
Santa Maria, CA 93454
Phone (805) 332-8446

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 1

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": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1811457625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 S STRATFORD AVE STE B",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545908",
            "telephone_number": "805-332-8446",
            "fax_number": "805-332-8483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 S STRATFORD AVE STE B",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545908",
            "telephone_number": "805-332-8446",
            "fax_number": "805-332-8483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ AMENERO",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A196008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.