NPIMap

Organization Active NPI

Diagnostic Pathology Services of the Central Coast

  • Anatomic Pathology & Clinical Pathology Physician
  • Santa Maria, CA
National Provider Identifier
1942549068
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
05D0587424 Issued in CA
Legal business name
DIAGNOSTIC PATHOLOGY SERVICES OF THE CENTRAL COAST
Practice address
1400 E Church St
Santa Maria, CA 93454-5906
Phone
(805) 541-6033
NPI assigned
Feb 8, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Authorized official

Name
Kevin Ferguson, MDNPI 1801823067
Title
President
Phone
(805) 548-1550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X 05D0587424 CA Primary

Addresses

Primary practice location

1400 E Church St
Santa Maria, CA 93454-5906

Mailing address

PO Box 5158
San Luis Obispo, CA 93403-5158
Phone (805) 548-1550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130503000167 CA Part B Supplier - Clinic/Group Practice 4284871658 Receives reassigned benefits from 15 practitioners
Practice locations: Lompoc, CA; Santa Maria, CA

National Provider Directory

National Provider Directory

Locations

1414 E Main St
Ste 102
Santa Maria, CA 93454
Phone (805) 548-1550

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)…

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1360281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1942549068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5158",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934035158",
            "telephone_number": "805-548-1550",
            "fax_number": "805-548-1876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E CHURCH ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545906",
            "telephone_number": "805-541-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC PATHOLOGY SERVICES OF THE CENTRAL COAST",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-08",
        "last_updated": "2023-09-07",
        "certification_date": "2022-08-17",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-548-1550",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "05D0587424",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 7, 2023; 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.