Individual provider Active NPI

Gerald Michael Kovar, M.D.

  • Internal Medicine Physician
  • Tarzana, CA
National Provider Identifier
1306883699
Registry record updated Jul 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G22853 Issued in CA
Practice address
5620 Wilbur Ave
Suite 221
Tarzana, CA 91356-1351
Phone
(818) 774-9225
Fax
(818) 774-9225
NPI assigned
Jun 2, 2006
Last updated
Jul 26, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G22853 CA Primary

Addresses

Primary practice location

5620 Wilbur Ave
Suite 221
Tarzana, CA 91356-1351

Mailing address

23528 Arminta St
Canoga Park, CA 91304-5803

Other identifiers 1

IdentifierTypeStateIssuer
00G228530MedicaidCA

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
I20080326000394 CA Practitioner - Internal Medicine 9234215658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Southern California Keck School of Medicine, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18401 Burbank Blvd
Suite 112
Tarzana, CA 91356-2875
Phone 8187749225749225

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G22853CAMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: gerald.kovar.1@12178.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185408000000",
    "number": "1306883699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23528 ARMINTA ST",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913045803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 WILBUR AVE",
            "address_2": "SUITE 221",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913561351",
            "telephone_number": "818-774-9225",
            "fax_number": "818-774-9225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVAR",
        "first_name": "GERALD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2007-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G22853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G228530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.