Monterey Bay Gi Consultants Medical Group Inc.
Organization Active NPI Gastroenterology Physician · Monterey, CA
NPI 1154373280 · NPPES record last updated Mar 27, 2023
Key facts
- NPI
- 1154373280
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Gastroenterology Physician 207RG0100X
- Legal business name
- MONTEREY BAY GI CONSULTANTS MEDICAL GROUP INC.
- Practice address
- 23 Upper Ragsdale Dr
Suite 200
Monterey, CA 93940-5771 - Phone
- (831) 375-3577
- Fax
- (831) 375-1478
- NPI assigned
- May 17, 2006
- Organization subpart
- No
Authorized official
- Name
- Daniel Gregory Luba, MD
- Title
- Medical Director
- Phone
- (831) 375-3577
Practitioners 30
-
Jeffrey Peter Fiorenza, M.D.
-
David Gardner, MD
-
Richard Walter Hell, M.D.
-
Jan Kamler, MD
-
Toby J Katz, M.D.
-
Jeffrey Thomas Keating, M.D.
-
Alexandra Lauren Lathos, MSN, APRN,FNP-C, ATC
-
Michael Sang Le, M.D.
-
Daniel Gregory Luba, M.D.
-
Michael Joel Mendoza, M.D.
-
Isabelle Barnard Moonan, M.D.
-
Kylie Shaffer, FNP-C
-
Lara Shipley, FNP
-
Kathryn A Swanson, M.D.
-
Anthony Anwar Razzak, M.D.
-
Harita Bhatt, PA
-
Douglas M Dalitz, CRNA
-
Megan Fulton, CRNA
-
Lloyd R Garren, M.D.
-
Christian Lloyd Hansen, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0590717 | Monterey Bay Gi Consultants Medical Group, Inc | Compliance | Jan 22, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041208000983 | CA | Part B Supplier - Clinic/Group Practice | 1153387386 |
Receives reassigned benefits from 30 practitioners Practice locations: Monterey, CA; Salinas, CA; Soledad, CA |
National Provider Directory
Locations
212 San Jose St
Ste 201
Salinas, CA 93901
Interoperability endpoints
- https://api.platform.athenahealth.com/11462/brand/2/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician |
207RG0100X | CA | Yes |
Addresses
Primary practice location
23 Upper Ragsdale Dr
Suite 200
Monterey, CA 93940-5771
Mailing address
23 Upper Ragsdale Dr
Suite 200
Monterey, CA 93940-5771
Phone (831) 375-3577
Other practice location 1
212 San Jose St Ste 200
Salinas, CA 93901-3928
Phone (831) 375-3577
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR00226840 | Medicaid | CA |
Other providers in Monterey, CA
- Monterey Acupuncture
- Monterey Bay Anesthesia, a Professional Nursing Corporation
- Monterey Bay Center for Integrated Health
- Monterey Bay Emergency Physicians Medical Corporation
- Monterey Bay Endoscopy Center LLC
- Monterey Bay Independent Physician Association, Inc.
- Monterey Bay Inpatient Phys
- Monterey Bay Observation Medicine
- Monterey Bay Oncology
- Monterey Bay Oncology a Medical Corporation
All providers in Monterey, CA · Gastroenterology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.