Individual provider Active NPI

Michael Frost, M.D.

  • Clinical Pathology/Laboratory Medicine Physician
  • San Luis Obispo, CA
National Provider Identifier
1982631016
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
License
A72558 Issued in CA
Practice address
3701 S Higuera St
Ste 200
San Luis Obispo, CA 93401-7462
Phone
(805) 541-6033
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Pathology) Physician 207ZH0000X A72558 CA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A72558 CA
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X A72558 CA Primary

Addresses

Primary practice location

3701 S Higuera St
Ste 200
San Luis Obispo, CA 93401-7462

Mailing address

PO Box 8139
San Luis Obispo, CA 93403-8139
Phone (805) 541-6033

Other identifiers 3

IdentifierTypeStateIssuer
00A725580MedicaidCA
LAB43503FMedicaidCA
GR0058760MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060124000814 CA Practitioner - Pathology 4981628336 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A72558CAMDHematology (Pathology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Pathology Services of the Central Coast Anatomic Pathology & Clinical Pathology CurrentSince Feb 4, 2013 Accepting new patients
Dignity Health Past Accepting new patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients
Twin Cities Community Hospital, Inc. Past Accepting new patients
Pathology Medical Group of Saint John'S Anatomic Pathology & Clinical Pathology Past Accepting new patients
Dignity Community Care Past Accepting new patients
Central Coast Pathology Consultants, Inc Past Accepting new patients

Locations

1400 E Church St
Santa Maria, CA 93454
Phone (805) 739-3000

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

Organizations & group practices 7

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1982631016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8139",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934038139",
            "telephone_number": "805-541-6033",
            "fax_number": "805-549-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 S HIGUERA ST",
            "address_2": "STE 200",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017462",
            "telephone_number": "805-541-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FROST",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "CA",
            "license": "A72558",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A72558",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "CA",
            "license": "A72558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A725580",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB43503F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0058760",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.