Individual provider Active NPI

Philis Denise Ransom, M.D.

  • Obstetrics & Gynecology Physician
  • San Bernardino, CA
National Provider Identifier
1396914545
Registry record updated Jun 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A100123 Issued in CA
Practice address
742 W Highland Ave
San Bernardino, CA 92405
Phone
(909) 881-7320
Fax
(909) 881-7330
NPI assigned
Feb 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A100123 CA Primary

Addresses

Primary practice location

742 W Highland Ave
San Bernardino, CA 92405

Mailing address

742 W Highland Ave
San Bernardino, CA 92405-3839
Phone (909) 881-7320

Other practice location 1

4240 Highland Ave
Suite B
Highland, CA 92346-2764
Phone (909) 864-4700

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
I20100330001154 CA Practitioner - Obstetrics/Gynecology 9032245949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Loma Linda University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Marcos Medical Group IncGroup PAC ID 0749222495, 8 clinicians

Practice addresses (Care Compare)

742 W Highland Ave
San Bernardino, CA 92405-4273
Phone (909) 881-7320

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A100123CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Marcos Medical Group Inc Obstetrics & Gynecology CurrentSince Jun 30, 2019 Accepting new patients
San Marcos Medical Group Inc. Past Accepting new patients
San Marcos Medical Group Inc. Past Accepting new patients
San Marcos Medical Group Inc. Past Accepting new patients

Locations

14980 Summit Ave
Ste 230
Fontana, CA 92336
Phone (909) 803-1160

7965 Sierra Ave
Ste E
Fontana, CA 92336
Phone (909) 356-4459

7576 Sterling Ave
Ste Cd
San Bernardino, CA 92410
Phone (909) 381-8983

1574 W Base Line St
Ste 107
Sn Bernrdno, CA 92411
Phone (909) 386-1880

742 W Highland Ave
Sn Bernrdno, CA 92405
Phone (909) 881-7320

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: philis.ransom.p1@direct.metro.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561766400000",
    "number": "1396914545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 W HIGHLAND AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924053839",
            "telephone_number": "909-881-7320",
            "fax_number": "909-881-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 W HIGHLAND AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92405",
            "telephone_number": "909-881-7320",
            "fax_number": "909-881-7330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4240 Highland Ave",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Highland",
            "state": "CA",
            "postal_code": "923462764",
            "country_code": "US",
            "telephone_number": "909-864-4700",
            "fax_number": "909-864-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANSOM",
        "first_name": "PHILIS",
        "middle_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-21",
        "last_updated": "2019-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A100123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.