Active NPI
David Ashen-Garry, DO
- Pediatrics Physician
- Long Beach, CA
National Provider Identifier
1164916474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 20A21123
- Practice address
- 2701 Atlantic Avenue
Long Beach, CA 90806 - Phone
- (714) 377-6993
- Fax
- (562) 427-1987
- NPI assigned
- Jun 20, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Hospice and Palliative Medicine Physician | 2080H0002X | 20A21123 | CA | |
| Pediatrics Physician | 208000000X | 20A21123 | CA | Primary |
| Pediatrics Physician | 208000000X | 5101024057 | MI |
Addresses
Primary practice location
2701 Atlantic Avenue
Long Beach, CA 90806
Mailing address
2701 Atlantic Avenue
Long Beach, CA 90806
Phone (714) 377-6993
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://memorialcare.org/fhir/api/FHIR/R4/ | Health Information Exchange (HIE) | MemorialCare Medical Foundation |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21123 | CA | MD | Marriage & Family Therapist |
| 20A21123 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorialcare Medical Foundation | Pediatrics | Current | Accepting new patients |
| Bristol Park Medical Group, Inc | Pediatrics | Past | Accepting new patients |
Locations
722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300
17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592
2701 Atlantic Ave
Long Beach, CA 90806
Phone (562) 684-8096
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- dashengarry795960@direct.memorialcare.org
- dashengarry1834116@direct.trinity-health.org
Organizations & group practices 2
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": "1529452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686096000000",
"number": "1164916474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 ATLANTIC AVENUE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90806",
"telephone_number": "714-377-6993",
"fax_number": "562-427-1987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 ATLANTIC AVENUE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90806",
"telephone_number": "714-377-6993",
"fax_number": "562-427-1987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ASHEN-GARRY",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-20",
"last_updated": "2023-06-07",
"certification_date": "2023-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "2080H0002X",
"taxonomy_group": "",
"desc": "Pediatrics, Hospice and Palliative Medicine",
"state": "CA",
"license": "20A21123",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "20A21123",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "5101024057",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
"affiliation": "Y",
"endpointDescription": "MemorialCare FHIR Endpoint",
"affiliationName": "MemorialCare Medical Foundation",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "17360 Brookhurst St",
"city": "Fountain Valley",
"state": "CA",
"country_code": "US",
"postal_code": "927083720",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.