NPIMap

Individual provider Active NPI

Geraldine Gardner, D.O.

  • Cardiovascular Disease Physician
  • La Grande, OR
National Provider Identifier
1033101696
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
DO194314 Issued in OR
Practice address
900 Sunset Dr
La Grande, OR 97850-1387
Phone
(541) 963-2328
Fax
(541) 975-5210
NPI assigned
Aug 19, 2005
Last updated
Aug 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X OP60308505 WA
Cardiovascular Disease Physician 207RC0000X DO194314 OR Primary
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 3

IdentifierTypeStateIssuer
123264900MedicaidWY
2016356MedicaidNV
500769777MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20191126001087 OR Practitioner - Cardiovascular Disease (Cardiology) 5597791939 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
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 IncGroup PAC ID 0547170789, 97 clinicians

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

Merit-based Incentive Payment System (MIPS)

Final score
97.65 of 100Reported as individual
Quality
92.08
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A6134CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grande Ronde Hospital, Inc. CurrentSince Sep 19, 2019 Accepting new patients
Grande Ronde Hospital, Inc. CurrentSince Sep 19, 2019 Accepting new patients
Sierra Nevada Cardiology Associates Catheterization Laboratory PastSince Jul 1, 2001 Accepting new patients
CTH Physicians Clinic Past Accepting new patients
Digestive Health Associates of Cheyenne Past Accepting new patients
Renown Regional Medical Center Past Accepting new patients

Locations

900 Sunset Dr
La Grande, OR 97850
Phone (541) 963-8421

Organizations & group practices 6

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 12

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": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1033101696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3290",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978507290",
            "telephone_number": "541-963-2328",
            "fax_number": "541-975-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SUNSET DR",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978501387",
            "telephone_number": "541-963-2328",
            "fax_number": "541-975-5210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "GERALDINE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-19",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "OP60308505",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "DO194314",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NV",
            "license": "822",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WY",
            "license": "7383A",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "20A6134",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123264900",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2016356",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500769777",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grande, OR

Sources for this page

Verify at the official NPI Registry.