Individual provider Active NPI

Jessy Mackenzie Arthurs, PA

  • Dermatology Physician
  • San Luis Obispo, CA
National Provider Identifier
1922589548
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
56033 Issued in CA
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

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250401002111 CA Practitioner - Physician Assistant 3678096542 Reassigns benefits to 1 organization

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
Coastal Family Dermatology PCGroup PAC ID 3678899051, 8 clinicians

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

LicenseStateTypeSpecialty
PA56033CAMDPediatrics 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.

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

Verify at the official NPI Registry.