NPIMap

Individual provider Active NPI

Michael Raymond Gagnon, MD

  • Ophthalmology Physician
  • Pleasanton, CA
National Provider Identifier
1164525598
Registry record updated May 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A95523 Issued in CA
Practice address
5575 W Las Positas Blvd
Suite 240
Pleasanton, CA 94588
Phone
(925) 460-5000
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A95523 CA Primary
Ophthalmology Physician 207W00000X 5852453 UT

Addresses

Primary practice location

5575 W Las Positas Blvd
Suite 240
Pleasanton, CA 94588

Mailing address

5575 W Las Positas Blvd
Suite 240
Pleasanton, CA 94588
Phone (925) 460-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070828001077 CA Practitioner - Ophthalmology 4183650146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Creighton University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gagnon Vision Medical Group IncGroup PAC ID 6103054937, 7 clinicians

Practice addresses (Care Compare)

5575 W Las Positas Blvd
Suite 240
Pleasanton, CA 94588-5803
Phone (925) 460-5000

Hospital & facility affiliations

  • Stanford Health Care Tri-Valley Hospital, Pleasanton, CA, CCN 050283
  • San Ramon Regional Medical Center Hospital, San Ramon, CA, CCN 050689
  • Stanford Health Care Hospital, Stanford, CA, CCN 050441

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery593

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95523CAMDSocial Worker
A95523CAMDOphthalmology Physician
5852453UTMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gagnon Vision Medical Group Inc Ophthalmology CurrentSince Jan 1, 2014 Accepting new patients
Gagnon Vision Medical Group Inc Ophthalmology CurrentSince Jan 1, 2014 Accepting new patients
John Muir Health Past Accepting new patients
San Ramon Regional Medical Center, LLC Past Accepting new patients
Stanford Health Care Tri-Valley Past Accepting new patients
John Muir Health Past Accepting new patients
Ahp of Georgia, LLC PastSince Aug 1, 2004 Accepting new patients

Locations

28 Fenton St
Livermore, CA 94550
Phone (925) 449-4000

5575 W Las Positas Blvd
Ste 240
Pleasanton, CA 94588
Phone (925) 460-5000

Interoperability endpoints

  • Direct secure messaging: mgagnon@vecma.intellechartdirect.net

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368057600000",
    "number": "1164525598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5575 W LAS POSITAS BLVD",
            "address_2": "SUITE 240",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "94588",
            "telephone_number": "925-460-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 W LAS POSITAS BLVD",
            "address_2": "SUITE 240",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "94588",
            "telephone_number": "925-460-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "MICHAEL",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2013-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A95523",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "UT",
            "license": "5852453",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.