Individual provider Active NPI

Joshua Gunpat

  • Family Medicine Physician
  • Lakeside, CA
National Provider Identifier
1114458775
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
191201 Issued in CA
Practice address
10039 Vine St
Lakeside, CA 92040-3120
Phone
(833) 867-4642
NPI assigned
Mar 24, 2017
Last updated
Feb 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D89395 MD
Family Medicine Physician 207Q00000X 0101272132 VA
Family Medicine Physician 207Q00000X MD049150 DC
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 191201 CA Primary

Addresses

Primary practice location

10039 Vine St
Lakeside, CA 92040-3120

Mailing address

525 Olive St Apt 812
San Diego, CA 92103-6341

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
I20240506003646 CA Practitioner - Family Practice 3173896594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neighborhood HealthcareGroup PAC ID 5294649406, 153 clinicians

Practice addresses (Care Compare)

10039 Vine St
Lakeside, CA 92040-3120
Phone (619) 390-9975

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
191201CAMDFamily Medicine Physician
MD049150DCMDFamily Medicine Physician
0101272132VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Healthcare General Practice CurrentSince Mar 11, 2024 Accepting new patients
Neighborhood Healthcare General Practice CurrentSince Mar 11, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

855 E Madison Ave
El Cajon, CA 92020
Phone (619) 440-2751

425 N Date St
Escondido, CA 92025
Phone (760) 737-2035

425 N Date St
#0
Escondido, CA 92025

10039 Vine St
Lakeside, CA 92040
Phone (619) 390-9975

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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 3

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": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1114458775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 OLIVE ST APT 812",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921036341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10039 VINE ST",
            "city": "LAKESIDE",
            "state": "CA",
            "postal_code": "920403120",
            "telephone_number": "833-867-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNPAT",
        "first_name": "JOSHUA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-24",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D89395",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101272132",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD049150",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "191201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeside, CA

Sources for this page

Verify at the official NPI Registry.