Active NPI
Jessy Mackenzie Arthurs, PA
- Dermatology Physician
- San Luis Obispo, CA
National Provider Identifier
1922589548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 56033
- Practice address
- 892 Aerovista PL Ste 120
San Luis Obispo, CA 93401-8054 - Phone
- (805) 544-5567
- NPI assigned
- Aug 22, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | PA56033 | CA | |
| Physician Assistant | 363A00000X | |||
| Dermatology Physician | 207N00000X | 56033 | CA | Primary |
Addresses
Primary practice location
892 Aerovista PL Ste 120
San Luis Obispo, CA 93401-8054
Mailing address
PO Box 1296
Templeton, CA 93465-1296
Phone (805) 610-2516
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
892 Aerovista PL
Suite 120
San Luis Obispo, CA 93401-8054
Phone (805) 544-5567
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA56033 | CA | MD | Pediatrics 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 and National Provider Directory roles.
-
- Pediatric Dermatology Physician
- San Luis Obispo, CA
- NPI 1174927073
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754956800000",
"number": "1922589548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1296",
"city": "TEMPLETON",
"state": "CA",
"postal_code": "934651296",
"telephone_number": "805-610-2516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "892 AEROVISTA PL STE 120",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934018054",
"telephone_number": "805-544-5567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARTHURS",
"first_name": "JESSY",
"middle_name": "MACKENZIE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-22",
"last_updated": "2025-08-12",
"certification_date": "2025-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "PA56033",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "56033",
"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 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.