Individual provider Active NPI

Brock Allen Mason, D.O.

  • Aerospace Medicine Physician
  • Santa Maria, CA
National Provider Identifier
1821408931
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Aerospace Medicine PhysicianTaxonomy code 2083A0100X
License
006745 Issued in AZ
Practice address
1400 E Church St
Santa Maria, CA 93454-5906
Phone
(480) 209-3565
NPI assigned
Apr 29, 2014
Last updated
Jun 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 19625 CA
Aerospace Medicine Physician 2083A0100X 006745 AZ Primary
General Practice Physician 208D00000X SL1008 NV

Addresses

Primary practice location

1400 E Church St
Santa Maria, CA 93454-5906

Mailing address

379 N Thompson Ave
Nipomo, CA 93444-9022
Phone (480) 209-3565

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
I20221013002541 CA Practitioner - Anesthesiology 4789984659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Medical Group of Santa Maria IncGroup PAC ID 9537143078, 20 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19625CAMDMental Health Counselor
006745AZMDAerospace Medicine Physician
SL1008NVMDGeneral Practice Physician

Organizations & group practices 1

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 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": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1821408931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 N THOMPSON AVE",
            "city": "NIPOMO",
            "state": "CA",
            "postal_code": "934449022",
            "telephone_number": "480-209-3565"
        },
        {
            "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": "480-209-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "BROCK",
        "middle_name": "ALLEN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-29",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "19625",
            "primary": false
        },
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "AZ",
            "license": "006745",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NV",
            "license": "SL1008",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.