Active NPI
Bruce Gewertz, M.D.
- Vascular Surgery Physician
- Los Angeles, CA
National Provider Identifier
1255434890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- G87711
- Practice address
- 8700 Beverly Blvd.
Los Angeles, CA 90048-1865 - Phone
- (310) 423-5884
- Fax
- (310) 423-0231
- NPI assigned
- Sep 7, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | G87711 | CA | Primary |
Addresses
Primary practice location
8700 Beverly Blvd.
Los Angeles, CA 90048-1865
Mailing address
PO Box 512717
Los Angeles, CA 90051-0717
Phone (310) 423-5884
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070426000578 | CA | Practitioner - Vascular Surgery | 2264344506 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G87711 | CA | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cedars-Sinai Medical Center | Current | Accepting new patients | |
| Cedars-Sinai Medical Center | Current | Accepting new patients |
Locations
4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780
8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291
8700 Beverly Blvd
Ste 8215
West Hollywood, CA 90048
Phone (310) 423-5874
Interoperability endpoints
- bgewertz102780@direct.cshs.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.
-
- Pharmacy
- Los Angeles, CA
- NPI 1376514810
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": "1274832000000",
"number": "1255434890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 512717",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900510717",
"telephone_number": "310-423-5884",
"fax_number": "310-423-0231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8700 BEVERLY BLVD.",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900481865",
"telephone_number": "310-423-5884",
"fax_number": "310-423-0231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEWERTZ",
"first_name": "BRUCE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-07",
"last_updated": "2010-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "CA",
"license": "G87711",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; 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.