Individual provider Active NPI

Ildiko Christine Gerbatsch-Bornemisza, MD

  • Adult Medicine Physician
  • San Diego, CA
National Provider Identifier
1134258148
Registry record updated Dec 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
A63645 Issued in CA
Practice address
3490 Palm Ave
San Diego, CA 92154-1664
Phone
(619) 423-5616
Fax
(619) 423-8564
NPI assigned
Mar 5, 2007
Last updated
Dec 15, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X A63645 CA Primary

Addresses

Primary practice location

3490 Palm Ave
San Diego, CA 92154-1664

Mailing address

3490 Palm Ave
San Diego, CA 92154-1664
Phone (619) 423-5616

Other names 1

  • Ildiko Christine Gerbatsch Professional 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
I20140627002053 CA Practitioner - General Practice 6901851666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marcos Borrero M D IncGroup PAC ID 0446307045, 8 clinicians

Practice addresses (Care Compare)

3490 Palm Ave
San Diego, CA 92154-1664
Phone (619) 423-5616

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63645CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Marcos Borrero MD Inc General Practice CurrentSince Nov 1, 2015 Accepting new patients

Locations

3490 Palm Ave
San Diego, CA 92154
Phone (619) 423-1351

Interoperability endpoints

  • Direct secure messaging: gerbatsch-bornemisza.ildiko.006.0050203@mabo.meditab.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450137600000",
    "number": "1134258148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3490 PALM AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921541664",
            "telephone_number": "619-423-5616",
            "fax_number": "619-423-8564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3490 PALM AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921541664",
            "telephone_number": "619-423-5616",
            "fax_number": "619-423-8564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERBATSCH-BORNEMISZA",
        "first_name": "ILDIKO",
        "middle_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "A63645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ILDIKO",
            "last_name": "GERBATSCH",
            "middle_name": "CHRISTINE",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.