Individual provider Active NPI

Gulnar Poorsattar, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Camarillo, CA
National Provider Identifier
1033264999
Registry record updated Jan 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
C50561 Issued in CA
Practice address
400 Camarillo Ranch Rd
Suite 204
Camarillo, CA 93012-5901
Phone
(805) 482-5550
Fax
(805) 233-6367
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X C50561 CA Primary

Addresses

Primary practice location

400 Camarillo Ranch Rd
Suite 204
Camarillo, CA 93012-5901

Mailing address

400 Camarillo Ranch Rd
Suite 204
Camarillo, CA 93012-5901
Phone (805) 482-5550

Other identifiers 2

IdentifierTypeStateIssuer
00C505610MedicaidCA
260051440OtherCATAX ID #

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
I20120503000005 CA Practitioner - Internal MedicinePractitioner - Endocrinology 3971592676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Endocrinology
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

400 Camarillo Ranch Rd
Suite 204
Camarillo, CA 93012-5903
Phone (805) 482-5550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
33.01 of 100Reported as individual
Improvement activities
0
Cost
63.78

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50561CAMDGeneral Practice Dentistry
C50561CAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Diabetes, Endocrinology & Nutrition Endocrinology, Diabetes & Metabolism CurrentSince Jan 1, 2003 Accepting new patients

Locations

400 Camarillo Ranch Rd
Ste 204
Camarillo, CA 93012
Phone (805) 482-5550

1700 Lombard St
Ste 115
Oxnard, CA 93030
Phone (805) 482-5550

739 E Main St
Ventura, CA 93001
Phone (805) 653-5550

Organizations & group practices 1

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 1

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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391040000000",
    "number": "1033264999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CAMARILLO RANCH RD",
            "address_2": "SUITE 204",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125901",
            "telephone_number": "805-482-5550",
            "fax_number": "805-233-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CAMARILLO RANCH RD",
            "address_2": "SUITE 204",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125901",
            "telephone_number": "805-482-5550",
            "fax_number": "805-233-6367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POORSATTAR",
        "first_name": "GULNAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2014-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "C50561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C505610",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "260051440",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

Verify at the official NPI Registry.