Individual provider Active NPI

Bruce Gewertz, M.D.

  • Vascular Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1255434890
Registry record updated May 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
G87711 Issued in CA
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

Updated by the provider on May 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070426000578 CA Practitioner - Vascular SurgeryPractitioner - General Surgery 2264344506 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G87711CAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Center CurrentSince Jul 1, 2006 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Jul 1, 2006 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.