Individual provider Active NPI

Andrew Jay Gellens, MD

  • Gynecologic Oncology Physician
  • La Mesa, CA
National Provider Identifier
1164528741
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
G71477 Issued in CA
Practice address
8851 Center Dr 210
La Mesa, CA 91942
Phone
(619) 463-7775
Fax
(619) 463-4181
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X G71477 CA Primary

Addresses

Primary practice location

8851 Center Dr 210
La Mesa, CA 91942

Mailing address

8851 Center Dr 210
La Mesa, CA 91942
Phone (619) 463-7775

Other practice location 1

4060 Fairmount Ave
OB/GYN Department
San Diego, CA 92105
Phone (619) 280-7072

Other identifiers 1

IdentifierTypeStateIssuer
GR0043610OtherMEDICAL GROUP

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
I20120223000810 CA Practitioner - Obstetrics/Gynecology 8123209780 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
La Maestra Family Clinic, Inc. Current Accepting new patients
La Maestra Family Clinic, Inc. CurrentSince Dec 1, 2021 Accepting new patients
La Maestra Family Clinic, Inc. CurrentSince Dec 1, 2021 Accepting new patients

Locations

165 S 1st St
El Cajon, CA 92019
Phone (619) 312-0347

217 Highland Ave
National City, CA 91950
Phone (619) 280-4213

4060 Fairmount Ave
San Diego, CA 92105
Phone (619) 255-9155

Interoperability endpoints

  • Direct secure messaging: andrew.gellens.p1@direct.lamaestra.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1164528741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8851 CENTER DR 210",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "91942",
            "telephone_number": "619-463-7775",
            "fax_number": "619-463-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8851 CENTER DR 210",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "91942",
            "telephone_number": "619-463-7775",
            "fax_number": "619-463-4181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4060 Fairmount Ave",
            "address_2": "OB/GYN Department",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "92105",
            "country_code": "US",
            "telephone_number": "619-280-7072",
            "fax_number": "619-961-0804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GELLENS",
        "first_name": "ANDREW",
        "middle_name": "JAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "CA",
            "license": "G71477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL GROUP",
            "identifier": "GR0043610",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.