NPIMap

Organization Active NPI

Seven Star Medical Group Inc.

  • Surgery Physician
  • Hemet, CA
National Provider Identifier
1265035356
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SEVEN STAR MEDICAL GROUP INC.
Practice address
1225 E Latham Ave Ste a
Hemet, CA 92543-4423
Phone
(951) 766-0374
Fax
(951) 766-0601
NPI assigned
Nov 19, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Authorized official

Name
Rose Gutierrez
Title
Executive Director of Surgical Serv
Phone
(951) 765-1717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

1225 E Latham Ave Ste a
Hemet, CA 92543-4423

Mailing address

41889 Florida Ave
Hemet, CA 92544-5042
Phone (951) 652-8700

Other practice location 1

29826 Haun Rd Ste 200
Menifee, CA 92586-6547
Phone (951) 766-0374

Other names 1

  • Seven Star Surgery Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210401001919 CA Part B Supplier - Clinic/Group Practice 4789091026 Receives reassigned benefits from 27 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hemet, CA; Menifee, CA; Anaheim, CA

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Seven Star Medical Group Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1265035356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41889 FLORIDA AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925445042",
            "telephone_number": "951-652-8700",
            "fax_number": "888-827-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E LATHAM AVE STE A",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925434423",
            "telephone_number": "951-766-0374",
            "fax_number": "951-766-0601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29826 Haun Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Menifee",
            "state": "CA",
            "postal_code": "925866547",
            "country_code": "US",
            "telephone_number": "951-766-0374",
            "fax_number": "951-766-0601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SEVEN STAR MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-19",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "ROSE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF SURGICAL SERV",
        "authorized_official_telephone_number": "951-765-1717"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seven Star Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Seven Star Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hemet, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.