Individual provider Active NPI

Stephanie Marie Santos, PA-C

  • Physician Assistant
  • Santa Maria, CA
National Provider Identifier
1942843719
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
59279 Issued in CA
Practice address
116 S Palisade Dr Ste 208
Santa Maria, CA 93454-8906
Phone
(805) 922-3632
Fax
(805) 922-3522
NPI assigned
Oct 23, 2019
Last updated
Nov 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2447 NV
Physician Assistant 363A00000X 59279 CA Primary

Addresses

Primary practice location

116 S Palisade Dr Ste 208
Santa Maria, CA 93454-8906

Mailing address

116 S Palisade Dr Ste 208
Santa Maria, CA 93454-8906
Phone (805) 922-3632

Other practice location 1

2800 N Tenaya Way Ste 203
Las Vegas, NV 89128-1100
Phone (702) 202-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210726002724 NV Practitioner - Physician Assistant 6406259696 Reassigns benefits to 1 organization
I20231114002998 CA Practitioner - Physician Assistant 6406259696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J Robert West MD IncGroup PAC ID 8729990973, 141 clinicians

Practice addresses (Care Compare)

116 S Palisade Dr
Suite 208
Santa Maria, CA 93454-8906
Phone (805) 922-3632

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
85.17 of 100Reported as group
Quality
74.51
Promoting interoperability
92
Improvement activities
40
Cost
82.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
59279CAMDGeneral Practice Dentistry
PA2447NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
J Robert West, M.D., Inc Dermatology CurrentSince Dec 31, 2023 Accepting new patients

Locations

116 S Palisade Dr
Ste 208
Santa Maria, CA 93454
Phone (805) 347-2100

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1942843719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 S PALISADE DR STE 208",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934548906",
            "telephone_number": "805-922-3632",
            "fax_number": "805-922-3522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S PALISADE DR STE 208",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934548906",
            "telephone_number": "805-922-3632",
            "fax_number": "805-922-3522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 N Tenaya Way Ste 203",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891281100",
            "country_code": "US",
            "telephone_number": "702-202-2700",
            "fax_number": "702-307-5480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-23",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2447",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "59279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.