Scott E Robertson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A81709 Issued in CA

Practice address

877 Oak Park Blvd
Pismo Beach, CA 93449-3292

Phone

(805) 474-8450

Fax

(805) 474-8454

NPI assigned

Nov 29, 2005

Last updated

Mar 22, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Pacific Central Coast Health Centers

  dba Marian Community Clinic

  • Community Health Clinic/Center
  • Santa Maria, CA
  • NPI 1063496651
  Medicare reassignment NPD
• Pacific Central Coast Health Centers

  dba Fair Oaks Specialty Center

  • Community Health Clinic/Center
  • Arroyo Grande, CA
  • NPI 1831764117
  NPD
• Pacific Central Coast Health Centers

  dba Medical Clinic at Bayview

  • Community Health Clinic/Center
  • Los Osos, CA
  • NPI 1922497510
  NPD
• Pacific Central Coast Health Centers

  dba Monarch Village Health Center

  • Community Health Clinic/Center
  • Nipomo, CA
  • NPI 1417555061
  NPD (past)
• Pacific Central Coast Health Centers

  dba Dignity Health Women's Center - Southwest

  • Community Health Clinic/Center
  • Bakersfield, CA
  • NPI 1720752355
  NPD (past)
• VHS Outpatient Clinics, Inc.

  dba Abrazo Medical Group

  • Multi-Specialty Clinic/Center
  • Goodyear, AZ
  • NPI 1912979964

  Family Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1811970437",
    "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": "805-739-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 OAK PARK BLVD",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493292",
            "telephone_number": "805-474-8450",
            "fax_number": "805-474-8454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "SCOTT",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A81709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "7202506",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "00A817090",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "A81709",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Renfrow
• Dennis Raoul Richardson, O.D.
• Riffelchiropractic
• Rand Cecil Ritchie, MD
• Robertson Mamigonian Central Coast Chiropractic Inc
• Schuyler Siddoway Rockwood, DO
• Andrew Rodriguez, DPT
• Jennifer Marie-Caroline Rogez
• Carol N Rowsemitt, PHD, RN, FNP
• David Ruiz, MD

• Family Medicine Physician in Pismo Beach, CA
• Providers in Pismo Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.