Individual provider Active NPI

David Ashen-Garry, DO

  • Pediatrics Physician
  • Long Beach, CA
National Provider Identifier
1164916474
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20A21123 Issued in CA
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

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230709000027 CA Practitioner - Pediatric MedicinePractitioner - Hospice/Palliative Care 5597009811 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21123CAMDMarriage & Family Therapist
20A21123CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Pediatrics CurrentSince Aug 1, 2023 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

  • Direct secure messaging: dashengarry795960@direct.memorialcare.org
  • Direct secure messaging: 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

Verify at the official NPI Registry.