Individual provider Active NPI

Lawrence Mietus, MD

  • Specialist
  • Goleta, CA
National Provider Identifier
1831251552
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G60991 Issued in CA
Practice address
5662 Calle Real
Suite 341
Goleta, CA 93117-2317
Phone
(805) 886-7914
NPI assigned
Dec 16, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G60991 CA Primary

Addresses

Primary practice location

5662 Calle Real
Suite 341
Goleta, CA 93117-2317

Mailing address

5662 Calle Real
Suite 341
Goleta, CA 93117-2317
Phone (805) 886-7914

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
I20050915000403 CA Practitioner - Internal Medicine 7214960749 Reassigns benefits to 1 organization
Practice locations: Santa Barbara, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
60991CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Barbara County Auditor CurrentSince Jan 7, 2019 Accepting new patients
Santa Barbara County Auditor CurrentSince Jan 7, 2019 Accepting new patients
C & J Sciutto Enterprise Inc. Past Accepting new patients
Villa Blanca II, LLC Past Accepting new patients
Villa Rose Inc. Past Accepting new patients
Santa Barbara Cottage Hospital Past Accepting new patients
Carefree Senior Living in California, Inc. Past Accepting new patients
Investore, Inc Past Accepting new patients
SP Maravilla LLC Past Accepting new patients
Absolute Residential Care, Inc. Past Accepting new patients
Villa Blanca,LLC Past Accepting new patients
Abundant Care III Past Accepting new patients
Casa San Miguel, LLC Past Accepting new patients
Investore, Inc Past Accepting new patients
Villa Rose Acquisitions Past Accepting new patients
Abundant Care II Past Accepting new patients
Homecare Casa Rhoda #1, Inc. Past Accepting new patients
Heritage House Group Past Accepting new patients

Locations

300 N San Antonio Rd
Rm 107
Santa Barbara, CA 93110
Phone (805) 681-5461

Organizations & group practices 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1166227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1831251552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5662 CALLE REAL",
            "address_2": "SUITE 341",
            "city": "GOLETA",
            "state": "CA",
            "postal_code": "931172317",
            "telephone_number": "805-886-7914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5662 CALLE REAL",
            "address_2": "SUITE 341",
            "city": "GOLETA",
            "state": "CA",
            "postal_code": "931172317",
            "telephone_number": "805-886-7914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIETUS",
        "first_name": "LAWRENCE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G60991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goleta, CA

Sources for this page

Verify at the official NPI Registry.