Geraldine Gardner, D.O.
Individual provider Active NPI Cardiovascular Disease Physician · La Grande, OR
NPI 1033101696 · NPPES record last updated Aug 13, 2020
Key facts
- NPI
- 1033101696
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- DO194314 (OR)
- Practice address
- 900 Sunset Dr
La Grande, OR 97850-1387 - Phone
- (541) 963-2328
- Fax
- (541) 975-5210
- NPI assigned
- Aug 19, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 12
Medicare Care Compare profile
- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- College of Osteo Med of the Pacific at Pomona, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Grande Ronde Hospital Inc
Practice addresses (Care Compare)
900 Sunset Dr
La Grande, OR 97850-1362
900 Sunset Dr
La Grande, OR 97850-1387
Phone (541) 963-8421
Hospital & facility affiliations
- Grande Ronde Hospital
- St. Alphonsus Medical Center - Baker City
- Saint Alphonsus Regional Medical Center
- Saint Alphonsus Medical Center - Nampa
- Wallowa Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.65 of 100
- Quality
- 92.08
- Promoting interoperability
- 98
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191126001087 | OR | Practitioner - Cardiovascular Disease (Cardiology) | 5597791939 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 600 | NE | MD | Clinical Psychologist |
| 20A6134 | CA | MD | Cardiovascular Disease Physician |
| DO194314 | OR | MD | Cardiovascular Disease Physician |
| OP60308505 | WA | MD | Cardiovascular Disease Physician |
| 7383A | WY | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grande Ronde Hospital, Inc. | Current |
Accepting new patients | |
| Grande Ronde Hospital, Inc. | Current |
Accepting new patients | |
| CTH Physicians Clinic | Past | Accepting new patients | |
| Digestive Health Associates of Cheyenne | Past | Accepting new patients | |
| Sierra Nevada Cardiology Associates Catheterization Laboratory | Past |
Accepting new patients | |
| Renown Regional Medical Center | Past | Accepting new patients |
Locations
900 Sunset Dr
La Grande, OR 97850
Phone (541) 963-8421
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | OP60308505 | WA | |
| Cardiovascular Disease Physician | 207RC0000X | DO194314 | OR | Yes |
| Cardiovascular Disease Physician | 207RC0000X | 822 | NV | |
| Cardiovascular Disease Physician | 207RC0000X | 7383A | WY | |
| Cardiovascular Disease Physician | 207RC0000X | 20A6134 | CA |
Addresses
Primary practice location
900 Sunset Dr
La Grande, OR 97850-1387
Mailing address
PO Box 3290
La Grande, OR 97850-7290
Phone (541) 963-2328
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 123264900 | Medicaid | WY | |
| 500769777 | Medicaid | OR | |
| 2016356 | Medicaid | NV |
Other providers in La Grande, OR
- Dana Marie Gaerke
- Katie G Gallegos
- Crystal Galloway
- Kathy Deann Ganung
- Teodoro De Belen Garcia Jr.
- Colby Garth
- Dehanna Lyn Gascon
- Rachel Marie Gazeley
- Kaitlyn Gekeler
- Genesis Dermatology
All providers in La Grande, OR · Cardiovascular Disease Physician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.