Gabriel Stephan Niles, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A100831 Issued in CA

Practice address

12555 W Jefferson Blvd Ste 301
Los Angeles, CA 90066-7032

Phone

(424) 443-5555

Fax

(424) 443-5550

NPI assigned

Dec 28, 2005

Last updated

Nov 28, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

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

Specialty

Family PracticeAlso: Internal Medicine

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Saint Johns Medical FoundationGroup PAC ID 0840548624, 282 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint John's Health Center Hospital, Santa Monica, CA, CCN 050290

Merit-based Incentive Payment System (MIPS)

Final score

90.42 of 100Reported as group

Quality

96.07

Promoting interoperability

100

Improvement activities

40

Cost

71.98

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: gniles515010@oc.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Providence Saint Johns Medical Foundation

  dba Saint John's Physician Partners

  • Specialist
  • Santa Monica, CA
  • NPI 1770093734

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Desmond E. McGuire, M. D., Inc.

  • Ophthalmology Physician
  • Santa Ana, CA
  • NPI 1629187372
  NPD (past)
• Dignity Community Care

  dba Methodist Hospital of Sacramento

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1467560599
  NPD (past)
• Dignity Health

  dba Mercy San Juan Medical Center

  • General Acute Care Hospital
  • Carmichael, CA
  • NPI 1972541498
  NPD (past)
• Dr. Todd Forman, Inc.

  • Medical Specialty Clinic/Center
  • Newport Beach, CA
  • NPI 1730378902
  NPD (past)
• Prohealth Partners a Medical Group Inc

  • Internal Medicine Physician
  • Lakewood, CA
  • NPI 1093848509

  Family Medicine

  NPD (past)
• Heal Doctors, P.C.

  • General Practice Physician
  • Charlotte, NC
  • NPI 1174121867
  NPD (past)
• Vis a Vis at Home Medical of Ny P.C.

  dba Heal Doctors

  • General Practice Physician
  • Brooklyn, NY
  • NPI 1285017277
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Saint John's Health Center

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1124026273
  Care Compare affiliation

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1285611699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12555 W JEFFERSON BLVD # 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900667032",
            "telephone_number": "424-443-5555",
            "fax_number": "424-443-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12555 W JEFFERSON BLVD STE 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900667032",
            "telephone_number": "424-443-5555",
            "fax_number": "424-443-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILES",
        "first_name": "GABRIEL",
        "middle_name": "STEPHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD6030955",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A100831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA MEDICAID PROVIDER ID",
            "identifier": "2045010",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G8940666",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gniles515010@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "12555 W Jefferson Blvd Ste 301",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900667032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nikzad Nafisi Dental Corp (kiss dental care)
• Vida Nikzad, PSYD
• Leonor Guevara Nila, LCSW
• Nile Medical Supplies
• Nile Medical Supplies Inc.
• Dorna Alyeshmerni Nili, MS
• Michael Adrian Nili
• Nina Mahyar Nili, LMFT
• Parissa Nili, PSYD
• Rekha Nilkanth, P.T.

• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.