Individual provider Active NPI

Mary Kosko Oates, MD

  • Physical Medicine & Rehabilitation Physician
  • Santa Maria, CA
National Provider Identifier
1881703759
Registry record updated Jan 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
G72477 Issued in CA
Practice address
116 South Palisade Drive
Suite 200
Santa Maria, CA 93454-8905
Phone
(805) 739-3968
Fax
(805) 739-3051
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X G72477 CA Primary

Addresses

Primary practice location

116 South Palisade Drive
Suite 200
Santa Maria, CA 93454-8905

Mailing address

117 West Bunny Avenue
Santa Maria, CA 93458-2805
Phone (805) 739-3968

Other identifiers 1

IdentifierTypeStateIssuer
CB216449OtherCAMEDICARE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72477CAMDPharmacist
G72477CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Central Coast Health Centers Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mary.oates.1@2692.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453075200000",
    "number": "1881703759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 WEST BUNNY AVENUE",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934582805",
            "telephone_number": "805-739-3968",
            "fax_number": "805-739-3051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 SOUTH PALISADE DRIVE",
            "address_2": "SUITE 200",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934548905",
            "telephone_number": "805-739-3968",
            "fax_number": "805-739-3051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OATES",
        "first_name": "MARY",
        "middle_name": "KOSKO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "G72477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "CB216449",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.