NPIMap

Individual provider Active NPI

Miriam Rocio Delosantos, PA-C, L.AC.

  • Physician Assistant
  • Ventura, CA
National Provider Identifier
1992991095
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 22859 Issued in CA
Practice address
138 W Main St
#E
Ventura, CA 93001-2584
Phone
(805) 667-2850
NPI assigned
Sep 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 12171 CA
Physician Assistant 363A00000X PA 22859 CA Primary

Addresses

Primary practice location

138 W Main St
#E
Ventura, CA 93001-2584

Mailing address

138 W Main St Ste E
Ventura, CA 93001-2584
Phone (805) 667-2850

Other practice location 1

3641 W 5th St
Oxnard, CA 93030-6424
Phone (805) 985-5505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140514000200 CA Practitioner - Physician Assistant 2466685847 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Memorial Health SystemGroup PAC ID 9537155676, 187 clinicians

Practice addresses (Care Compare)

138 W Main St
Suite E
Ventura, CA 93001-2584
Phone (805) 667-2850

147 N Brent St
Ventura, CA 93003-2809
Phone (805) 652-5011

3641 W 5TH St
Oxnard, CA 93030-6424
Phone (805) 985-5505

3655 W 5TH St
Oxnard, CA 93030-6424
Phone (805) 948-4442

Hospital & facility affiliations

  • Community Memorial Hospital - Ventura Hospital, Ventura, CA, CCN 050394

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 22859CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Memorial Health System CurrentSince Jun 7, 2014 Accepting new patients
Community Memorial Health System CurrentSince Jun 7, 2014 Accepting new patients
Serra Community Medical Clinic, Inc. CurrentSince Jan 6, 2014 Accepting new patients

Locations

422 Arneill Rd
Ste B
Camarillo, CA 93010
Phone (805) 383-4510

3641 W 5th St
Oxnard, CA 93030
Phone (805) 985-5505

2921 Saviers Rd
Oxnard, CA 93033
Phone (805) 487-5588

9375 San Fernando Rd
Sun Valley, CA 91352
Phone (818) 504-4700

5855 Olivas Park Dr
Ventura, CA 93003
Phone (805) 652-5469

138 W Main St
Ste E
Ventura, CA 93001
Phone (805) 667-2850

147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011

Interoperability endpoints

  • Direct secure messaging: miriamdelosantos@cfh.allscriptsdirect.net
  • Direct secure messaging: mdelosantos3514823@oc.providencedirect.org

Organizations & group practices 5

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.

Hospital & facility affiliations 10

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": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1992991095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 W MAIN ST STE E",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930012584",
            "telephone_number": "805-667-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 W MAIN ST",
            "address_2": "#E",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930012584",
            "telephone_number": "805-667-2850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3641 W 5th St",
            "address_purpose": "LOCATION",
            "city": "Oxnard",
            "state": "CA",
            "postal_code": "930306424",
            "country_code": "US",
            "telephone_number": "805-985-5505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELOSANTOS",
        "first_name": "MIRIAM",
        "middle_name": "ROCIO",
        "name_prefix": "Ms.",
        "credential": "PA-C, L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-21",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "12171",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 22859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.