Organization Active NPI

Gje Inc.

  • Internal Medicine Physician
  • Newbury Park, CA
National Provider Identifier
1114426541
Registry record updated Feb 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A123093 Issued in CA
Legal business name
GJE INC.
Practice address
5159 Via El Molino
Newbury Park, CA 91320-6995
Phone
(646) 734-2585
Fax
(805) 426-8649
NPI assigned
Feb 12, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2018

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

Authorized official

Name
Garry Forkosh, MDNPI 1750519385
Title
Sole Owner
Phone
(646) 734-2585

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A123093 CA Primary

Addresses

Primary practice location

5159 Via El Molino
Newbury Park, CA 91320-6995

Mailing address

5159 Via El Molino
Newbury Park, CA 91320-6995
Phone (646) 734-2585

Other identifiers 2

IdentifierTypeStateIssuer
A123093OtherCAMEDICAL LICENSE
1750519385OtherCATYPE 1 NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180327000184 CA Part B Supplier - Clinic/Group Practice 0547522831 Receives reassigned benefits from 2 practitioners
Practice locations: Newbury Park, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518393600000",
    "number": "1114426541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5159 VIA EL MOLINO",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913206995",
            "telephone_number": "646-734-2585",
            "fax_number": "805-426-8649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5159 VIA EL MOLINO",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913206995",
            "telephone_number": "646-734-2585",
            "fax_number": "805-426-8649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GJE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-12",
        "last_updated": "2018-02-12",
        "status": "A",
        "authorized_official_last_name": "FORKOSH",
        "authorized_official_first_name": "GARRY",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "646-734-2585",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A123093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A123093",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI",
            "identifier": "1750519385",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newbury Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.