Individual provider Active NPI

Andrew Scott Gersoff, M.D.

  • Internal Medicine Physician
  • Santa Barbara, CA
National Provider Identifier
1386664589
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G39885 Issued in CA
Practice address
345 Camino del Remedio
Santa Barbara, CA 93110-1332
Phone
(805) 681-5488
Fax
(805) 681-5200
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 G39885 CA Primary

Addresses

Primary practice location

345 Camino del Remedio
Santa Barbara, CA 93110-1332

Mailing address

300 N San Antonio Rd
Santa Barbara, CA 93110-1316
Phone (805) 681-5461

Other identifiers 2

IdentifierTypeStateIssuer
G39885OtherCAMED LICENSE
00G398850MedicaidCA

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
I20150714002824 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6709069388

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39885CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1386664589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N SAN ANTONIO RD",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931101316",
            "telephone_number": "805-681-5461",
            "fax_number": "805-681-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 CAMINO DEL REMEDIO",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931101332",
            "telephone_number": "805-681-5488",
            "fax_number": "805-681-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSOFF",
        "first_name": "ANDREW",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G39885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED LICENSE",
            "identifier": "G39885",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G398850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.