Individual provider Active NPI

Nani Gelvezon, D.O.

  • Surgery Physician
  • Monterey Park, CA
National Provider Identifier
1134427594
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
20A11327 Issued in CA
Practice address
600 N Garfield Ave Ste 210
Monterey Park, CA 91754-1170
Phone
(626) 573-8282
Fax
(626) 573-8338
NPI assigned
Mar 9, 2011
Last updated
Dec 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036136051 IL
Surgery Physician 208600000X 20A11327 CA Primary

Addresses

Primary practice location

600 N Garfield Ave Ste 210
Monterey Park, CA 91754-1170

Mailing address

2372 Morse Ave Ste 325
Irvine, CA 92614-6234
Phone (213) 357-4468

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
I20180813002380 CA Practitioner - General Surgery 3678898657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

600 N Garfield Ave
Suite 210
Monterey Park, CA 91754-1170
Phone (626) 281-9111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A11327CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Minimally Invasive Surgical Services, Inc., an Osteopathic Corporation Surgery CurrentSince Jul 1, 2018 Accepting new patients

Locations

600 N Garfield Ave
Ste 210
Monterey Park, CA 91754
Phone (626) 281-9111

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

Hospital & facility affiliations 4

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": "1299628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1134427594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2372 MORSE AVE STE 325",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146234",
            "telephone_number": "213-357-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N GARFIELD AVE STE 210",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541170",
            "telephone_number": "626-573-8282",
            "fax_number": "626-573-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELVEZON",
        "first_name": "NANI",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-09",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036136051",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "20A11327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

Verify at the official NPI Registry.