Organization Active NPI

General Surgery Medical Group of Ventura County

  • Surgery Physician
  • Oxnard, CA
National Provider Identifier
1275511644
Registry record updated Nov 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
GENERAL SURGERY MEDICAL GROUP OF VENTURA COUNTY
Practice address
1700 N Rose Ave
Suite 430
Oxnard, CA 93030-3790
Phone
(805) 485-8722
Fax
(805) 485-9311
NPI assigned
Jan 5, 2006
Last updated
Nov 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2008

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

Authorized official

Name
Dr. Timothy Gordon Bryant, M.D.NPI 1164425245
Title
Managing Partner
Phone
(805) 485-8722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

1700 N Rose Ave
Suite 430
Oxnard, CA 93030-3790

Mailing address

1700 N Rose Ave
Suite 430
Oxnard, CA 93030-3790
Phone (805) 485-8722

Other identifiers 2

IdentifierTypeStateIssuer
GR0027300MedicaidCA
YYY49967YOtherCABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040430000959 CA Part B Supplier - Clinic/Group Practice 6305833294 Receives reassigned benefits from 6 practitioners
Practice locations: Thousand Oaks, CA; Ventura, CA; Oxnard, CA; Ojai, CA; Camarillo, CA

National Provider Directory

National Provider Directory

Locations

2460 N Ponderosa Dr
Ste A117
Camarillo, CA 93010
Phone (805) 430-0002

1700 N Rose Ave
Ste 430
Oxnard, CA 93030
Phone (805) 485-8722

415 Rolling Oaks Dr
Ste 220
Thousand Oaks, CA 91361
Phone (805) 379-9696

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226534400000",
    "number": "1275511644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 N ROSE AVE",
            "address_2": "SUITE 430",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930303790",
            "telephone_number": "805-485-8722",
            "fax_number": "805-485-9311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N ROSE AVE",
            "address_2": "SUITE 430",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930303790",
            "telephone_number": "805-485-8722",
            "fax_number": "805-485-9311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERAL SURGERY MEDICAL GROUP OF VENTURA COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-05",
        "last_updated": "2008-11-13",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "805-485-8722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0027300",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "YYY49967Y",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2008; 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.