Innerbloom Ketamine Therapy
NPI 1184430696 · Integrative Medicine Physician · San Luis Obispo, CA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Innerbloom Ketamine Therapy is a Integrative Medicine Physician organization in San Luis Obispo, CA (NPI 1184430696).
Provider details
- NPI number
- 1184430696
- Entity type
- Organization
- Primary specialty
- Integrative Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ray Rivas, MD(805) 321-8471
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2024-12-09
- Last updated
- 2026-03-03
- Certified
- 2026-03-03
Frequently asked questions
- What is Innerbloom Ketamine Therapy's NPI number?
- Innerbloom Ketamine Therapy's National Provider Identifier (NPI) is 1184430696, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Innerbloom Ketamine Therapy?
- Innerbloom Ketamine Therapy is classified in the NPPES registry as Integrative Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Innerbloom Ketamine Therapy located?
- Innerbloom Ketamine Therapy's practice location on file with NPPES is 100 Casa St Ste D3, San Luis Obispo, CA 93405-5827.
- What is Innerbloom Ketamine Therapy's phone number?
- The practice phone number listed in the NPPES registry for Innerbloom Ketamine Therapy is (805) 321-8471.
- Does Innerbloom Ketamine Therapy accept Medicare?
- Innerbloom Ketamine Therapy is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Innerbloom Ketamine Therapy?
- The authorized official listed on Innerbloom Ketamine Therapy's NPPES record is Ray Rivas, MD. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Innerbloom Ketamine Therapy's NPI active?
- Yes — Innerbloom Ketamine Therapy's NPI (1184430696) is active in the NPPES registry as of the last update on 2026-03-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.