NPIMap

Organization Active NPI

Central Coast Physical Medicine and Rehabilitation Medical Group Inc.

  • Physical Medicine & Rehabilitation Physician
  • Santa Barbara, CA
National Provider Identifier
1942248174
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
CENTRAL COAST PHYSICAL MEDICINE AND REHABILITATION MEDICAL GROUP INC.
Practice address
2415 De la Vina St
Santa Barbara, CA 93105-3819
Phone
(805) 687-7444
Fax
(805) 687-3707
NPI assigned
Jun 2, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ross Barry, MD
Title
President
Phone
(805) 569-8922

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Physical Medicine & Rehabilitation Physician 208100000X NU Primary
Rehabilitation Practitioner 225400000X CA

Addresses

Primary practice location

2415 De la Vina St
Santa Barbara, CA 93105-3819

Mailing address

PO Box 1206
Goleta, CA 93116-1206
Phone (805) 569-8922

Other practice location 1

2320 Bath St Ste 315
Santa Barbara, CA 93105-4387
Phone (805) 569-8922

Other identifiers 1

IdentifierTypeStateIssuer
1942248174MedicaidCA

Other names 1

  • Rehabilitation Medical Group Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL @ccpmr.com Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090120000081 CA Part B Supplier - Clinic/Group Practice 1951473529 Receives reassigned benefits from 1 practitioner
Practice locations: Santa Barbara, CA

National Provider Directory

National Provider Directory

Locations

230 W Pueblo St
Ste A
Santa Barbara, CA 93105
Phone (805) 569-8922

2320 Bath St
Ste 315
Santa Barbara, CA 93105
Phone (805) 569-7236

3905 State St
Ste 7277
Santa Barbara, CA 93105

433 Camino del Remedio
Remedio
Santa Barbara, CA 93110
Phone (805) 683-7773

5266 Hollister Ave
Ste 200
Santa Barbara, CA 93111
Phone (805) 569-8922

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)…

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17346/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1942248174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1206",
            "city": "GOLETA",
            "state": "CA",
            "postal_code": "931161206",
            "telephone_number": "805-569-8922",
            "fax_number": "805-687-5467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 DE LA VINA ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931053819",
            "telephone_number": "805-687-7444",
            "fax_number": "805-687-3707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2320 Bath St Ste 315",
            "address_purpose": "LOCATION",
            "city": "Santa Barbara",
            "state": "CA",
            "postal_code": "931054387",
            "country_code": "US",
            "telephone_number": "805-569-8922",
            "fax_number": "805-687-5467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTRAL COAST PHYSICAL MEDICINE AND REHABILITATION MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2022-07-21",
        "certification_date": "2019-12-09",
        "status": "A",
        "authorized_official_last_name": "BARRY",
        "authorized_official_first_name": "ROSS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-569-8922",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942248174",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "@ccpmr.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Santa Barbara",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Santa Barbara",
            "address_1": "2320 Bath St Ste 315",
            "city": "Santa Barbara",
            "state": "CA",
            "country_code": "US",
            "postal_code": "931054387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Rehabilitation Medical Group",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Rehabilitation Medical Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Barbara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.