Individual provider Active NPI

Yelena Gambarin, M.D.

  • Internal Medicine Physician
  • Martinez, CA
National Provider Identifier
1043412026
Registry record updated Jan 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A100273 Issued in CA
Practice address
150 Muir Rd # Hbpc11C3
Martinez, CA 94553-4668
Phone
(925) 372-2131
NPI assigned
Jun 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A100273 CA Primary

Addresses

Primary practice location

150 Muir Rd # Hbpc11C3
Martinez, CA 94553-4668

Mailing address

319 Diablo Rd Ste 105
Danville, CA 94526-3428

Other names 1

  • Yelena Polovinchik Former name

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
I20210928002326 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3971647702

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A100273CAMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: yelena.gambarin@49412312072196.direct.elationemr.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643414400000",
    "number": "1043412026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 DIABLO RD STE 105",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945263428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MUIR RD # HBPC11C3",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945534668",
            "telephone_number": "925-372-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBARIN",
        "first_name": "YELENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-03",
        "last_updated": "2022-01-29",
        "certification_date": "2022-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A100273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YELENA",
            "last_name": "POLOVINCHIK",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Martinez, CA

Sources for this page

Verify at the official NPI Registry.