Jackson & Engberg Medical Corporation

Key facts

NPI: 1891711289
Entity type: Organization (NPI type 2)
Primary specialty: Family Medicine Physician 207Q00000X
Legal business name: JACKSON & ENGBERG MEDICAL CORPORATION
Practice address: 517 W Junipero St
Santa Barbara, CA 93105-4239
Phone: (805) 682-8844
Fax: (805) 682-4735
NPI assigned: Jul 15, 2006
Organization subpart: No

Authorized official

Name: Karen M Engberg, M.D.
Title: President
Phone: (805) 682-8844

Practitioners 10

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

Douglas E Cummings, M.D. Internal Medicine Physician · Santa Barbara, CA · NPI 1407876774

Medicare reassignment Care Compare group CA
Shaun Ehsani, MD Family Medicine Physician · Santa Barbara, CA · NPI 1306040712

Medicare reassignment Care Compare group CA
Blanca Estela Fernandez-Kline, MD Family Medicine Physician · Santa Barbara, CA · NPI 1679653927

Medicare reassignment Care Compare group CA
Jeffrey Garber, PA-C Physician Assistant · La Jolla, CA · NPI 1104220375

Medicare reassignment Care Compare group CA
Gina Analisa Grossi, PA-C, MMS Physician Assistant · Stanford, CA · NPI 1306076476

Medicare reassignment Care Compare group CA
Karen Marie Hanna Arndt, PA-C Medical Physician Assistant · Santa Barbara, CA · NPI 1598784225

Medicare reassignment Care Compare group CA
Janet Theresa Spagna, PA-C Physician Assistant · Goleta, CA · NPI 1609127034

NPD
Erica Gallen Family Nurse Practitioner · Santa Barbara, CA · NPI 1013319417

NPD (past)
Sherilyn Chantal Wheaton, M.D. Family Medicine Physician · Ventura, CA · NPI 1205861234

NPD (past) FAMILY MEDICINE
Elizabeth J Cardinale, MD Internal Medicine Physician · University Park, PA · NPI 1154585909

NPD (past) INTERNAL MEDICINE

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
05D2069762	Jackson Medical Group- Santa Barbara 517 W Junipero St, Santa Barbara, CA 93105	Certificate of waiver	Dec 2, 2027

Medicare participation

Medicare fee-for-service enrollment: Enrolled in CA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20090812000935	CA	Part B Supplier - Clinic/Group Practice	6103970983	Receives reassigned benefits from 6 practitioners Practice locations: Goleta, CA; Santa Barbara, CA

National Provider Directory

Locations

5565 Carpinteria Ave
Ste 4
Carpinteria, CA 93013
Phone (805) 682-8844

7127 Hollister Ave
Ste 2
Goleta, CA 93117
Phone (805) 682-8844

5333 Hollister Ave
Ste 110
Santa Barbara, CA 93111
Phone (805) 682-8844

Networks

BSC 65 PLUS INDIVIDUAL MAPD
Plans: 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)…

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Medicine Physician Group: 193200000X MULTI-SPECIALTY GROUP	207Q00000X			Yes
Internal Medicine Physician Group: 193200000X MULTI-SPECIALTY GROUP	207R00000X

Addresses

Primary practice location

517 W Junipero St
Santa Barbara, CA 93105-4239

Mailing address

517 W Junipero St
Santa Barbara, CA 93105-4239
Phone (805) 682-8844

Other identifiers

Identifier	Type	State	Issuer
1891711289	Other	CA	NPI

Other names

Jackson Medical Group Inc Doing business as

Other providers in Santa Barbara, CA

All providers in Santa Barbara, CA · Family Medicine Physician in California

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2014. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.