NPIMap

Organization Active NPI

General Vascular Surgery Medical Group, Inc.

  • Vascular Surgery Physician
  • San Leandro, CA
National Provider Identifier
1316982879
Registry record updated Feb 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
GENERAL VASCULAR SURGERY MEDICAL GROUP, INC.
Practice address
13851 E 14TH St
Suite 202
San Leandro, CA 94578-2631
Phone
(510) 347-4700
Fax
(510) 347-4712
NPI assigned
Jun 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2010

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

Authorized official

Name
Dr. Robert O. Gingery, M.D.NPI 1417974460
Title
President
Phone
(510) 347-4700

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
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

13851 E 14TH St
Suite 202
San Leandro, CA 94578-2631

Mailing address

13851 E 14TH St
Suite 202
San Leandro, CA 94578-2631
Phone (510) 347-4700

Other names 1

  • Noninvasive Vascular Laboratory Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040511001737 CA Part B Supplier - Clinic/Group Practice 1951390137 Receives reassigned benefits from 10 practitioners
Practice locations: San Leandro, CA; San Ramon, CA; Hayward, CA; Alameda, CA

National Provider Directory

National Provider Directory

Locations

2070 Clinton Ave
#3
Alameda, CA 94501
Phone (510) 521-4412

27200 Calaroga Ave
#101
Hayward, CA 94545
Phone (510) 347-4700

13851 E 14th St
#201202
San Leandro, CA 94578
Phone (510) 347-4700

13855 E 14th St
#2
San Leandro, CA 94578
Phone (510) 357-4006

13855 E 14th St
Fl 2
San Leandro, CA 94578
Phone (510) 347-4700

13851 E 14th St
Ste 201
San Leandro, CA 94578
Phone (510) 347-4700

100 Park Pl
#150
San Ramon, CA 94583
Phone (925) 275-0551

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1920/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265068800000",
    "number": "1316982879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13851 E 14TH ST",
            "address_2": "SUITE 202",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782631",
            "telephone_number": "510-347-4700",
            "fax_number": "510-347-4712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13851 E 14TH ST",
            "address_2": "SUITE 202",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782631",
            "telephone_number": "510-347-4700",
            "fax_number": "510-347-4712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERAL VASCULAR SURGERY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2010-02-02",
        "status": "A",
        "authorized_official_last_name": "GINGERY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-347-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Noninvasive Vascular Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; 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.