NPIMap

Organization Active NPI

Central Coast Orthopedic Medical Group

  • Orthopaedic Surgery Physician
  • San Luis Obispo, CA
National Provider Identifier
1871537779
Registry record updated Aug 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
CENTRAL COAST ORTHOPEDIC MEDICAL GROUP
Practice address
862 Meinecke Ave Ste 100
San Luis Obispo, CA 93405-3701
Phone
(805) 541-4600
Fax
(805) 541-3566
NPI assigned
Jun 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2026

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

Authorized official

Name
Monica Lopez
Title
Practice Manager
Phone
(805) 541-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

862 Meinecke Ave Ste 100
San Luis Obispo, CA 93405-3701

Mailing address

2342 Professional Pkwy Ste 200
Santa Maria, CA 93455-1690
Phone (805) 349-9545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040301000400 CA Part B Supplier - Clinic/Group Practice 8426945916 Receives reassigned benefits from 20 practitioners
Practice locations: Pismo Beach, CA; San Luis Obispo, CA; Santa Maria, CA; Templeton, CA

National Provider Directory

National Provider Directory

Locations

2342 Professional Pkwy
Ste 200
Santa Maria, CA 93455
Phone (805) 349-9545

525 Plaza Dr
Ste 203
Santa Maria, CA 93454
Phone (805) 349-9545

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787961600000",
    "number": "1871537779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2342 PROFESSIONAL PKWY STE 200",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934551690",
            "telephone_number": "805-349-9545",
            "fax_number": "805-349-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "862 MEINECKE AVE STE 100",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934053701",
            "telephone_number": "805-541-4600",
            "fax_number": "805-541-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL COAST ORTHOPEDIC MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2026-08-29",
        "certification_date": "2026-08-29",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "805-541-4600"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.