Individual provider Active NPI

Gautam Mohan Anand, M.D.

  • Vascular Surgery Physician
  • Inglewood, CA
National Provider Identifier
1356705453
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
A188755 Issued in CA
Practice address
575 E Hardy St Ste 322
Inglewood, CA 90301-4053
Phone
(310) 673-6950
NPI assigned
Apr 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 310326 NY
Vascular Surgery Physician 2086S0129X A188755 CA Primary

Addresses

Primary practice location

575 E Hardy St Ste 322
Inglewood, CA 90301-4053

Mailing address

575 E Hardy St Ste 322
Inglewood, CA 90301-4053
Phone (310) 673-6950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210707003361 NY Practitioner - Vascular Surgery 9638410293 Reassigns benefits to 1 organization
I20231212002553 CA Practitioner - Vascular Surgery 9638410293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Vascular Associates IncGroup PAC ID 7911901731, 5 clinicians

Practice addresses (Care Compare)

575 E Hardy St
Suite 322
Inglewood, CA 90301-4053
Phone (310) 673-6950

Hospital & facility affiliations

  • Centinela Hospital Medical Center Hospital, Inglewood, CA, CCN 050739

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)115

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A188755CAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, PC Current Accepting new patients
CHS Physician Partners, P.C CurrentSince Jun 18, 2021 Accepting new patients
University Vascular Associates Inc. Vascular Surgery CurrentSince Nov 1, 2023 Accepting new patients

Locations

575 E Hardy St
Ste 322
Inglewood, CA 90301
Phone (310) 671-0488

266 S Harvard Blvd
Ste 350
Los Angeles, CA 90004
Phone (213) 444-6255

1082 Glendon Ave
Los Angeles, CA 90024
Phone (310) 209-2011

500 Commack Rd
Unit 150D
Commack, NY 11725
Phone (318) 644-4996

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

48 Route 25A
Ste 303
Smithtown, NY 11787
Phone (631) 382-4833

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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

Hospital & facility affiliations 1

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": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1356705453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 E HARDY ST STE 322",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014053",
            "telephone_number": "310-673-6950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 E HARDY ST STE 322",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014053",
            "telephone_number": "310-673-6950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANAND",
        "first_name": "GAUTAM",
        "middle_name": "MOHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-05",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "310326",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A188755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.