Individual provider Active NPI

Gagan Pawar, MD

  • Family Medicine Physician
  • Ventura, CA
National Provider Identifier
1417110586
Registry record updated Aug 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A116898 Issued in CA
Practice address
200 S Wells Rd # 200
Ventura, CA 93004-1377
Phone
(805) 647-6322
NPI assigned
Jul 8, 2008
Last updated
Aug 10, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A116898 CA Primary

Addresses

Primary practice location

200 S Wells Rd # 200
Ventura, CA 93004-1377

Mailing address

200 S Wells Rd # 200
Ventura, CA 93004-1377
Phone (805) 647-6322

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
I20110816000598 CA Practitioner - Family Practice 5395914956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinicas del Camino Real IncGroup PAC ID 3173434396, 99 clinicians

Practice addresses (Care Compare)

1000 Newbury Rd
Suite 150
Newbury Park, CA 91320-6438
Phone (805) 498-3640

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A116898CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicas del Camino Real Inc CurrentSince Jul 2, 2011 Accepting new patients
Clinicas del Camino Real Inc CurrentSince Jul 2, 2011 Accepting new patients
Clinicas del Camino Real Inc Past Accepting new patients
Clinicas del Camino Real Inc Past Accepting new patients

Locations

1000 Newbury Rd
Ste 150
Newbury Park, CA 91320
Phone (805) 498-3640

500 E Main St
Santa Paula, CA 93060
Phone (805) 933-0895

200 S Wells Rd
#200
Ventura, CA 93004
Phone (805) 647-6322

Interoperability endpoints

  • Direct secure messaging: gagan.pawar.p1@direct.clinicas.nextgenshare.com
  • Direct secure messaging: gpawar802516@direct.ochin.org
  • Direct secure messaging: management.enhancedcare.p1@direct.clinicas.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 16

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Clinicas del Camino Real, Inc MaravillaOxnard, CA, CCN 551851 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Nov 1, 2021
Nov 1, 2021
Nov 1, 2021
Clinicas del Camino Real, Inc. OxnardOxnard, CA, CCN 051827 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Nov 1, 2021
Nov 1, 2021
Nov 1, 2021
Clinicas del Camino Real Inc, Newbury ParkNewbury Park, CA, CCN 051115 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Nov 1, 2021
Nov 1, 2021
Nov 1, 2021
Clinicas del Camino Real Inc El RioOxnard, CA, CCN 051172 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Apr 1, 2014
Apr 1, 2014
Apr 1, 2014
Clinicas del Camino Real , Inc VenturaVentura, CA, CCN 051861 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Apr 1, 2014
Apr 1, 2014
Apr 1, 2014
Clinicas del Camino Real, Inc., Santa PaulaSanta Paula, CA, CCN 551852 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Nov 1, 2021
Nov 1, 2021
Nov 1, 2021
Clinicas del Camino Real Inc, Ocean ViewOxnard, CA, CCN 551939 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Apr 1, 2014
Apr 1, 2014
Apr 1, 2014
Clinicas del Camino Real, Inc Karen Burnham Health CenterOxnard, CA, CCN 051025 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Nov 1, 2021
Nov 1, 2021
Nov 1, 2021
Ojai Valley Community Health CenterOjai, CA, CCN 551850 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Apr 1, 2014
Apr 1, 2014
Apr 1, 2014
Clinicas del Camino Real Inc FillmoreFillmore, CA, CCN 051860 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Nov 1, 2021
Nov 1, 2021
Nov 1, 2021
Clinicas del Camino Real Inc. Simi ValleySimi Valley, CA, CCN 551159 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Nov 1, 2021
Nov 1, 2021
Nov 1, 2021
Clinicas del Camino Real Inc MoorparkMoorpark, CA, CCN 551172 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Nov 1, 2021
Nov 1, 2021
Nov 1, 2021
Clinicas del Camino Real, Inc East Simi ValleySimi Valley, CA, CCN 751841 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Nov 1, 2021
Nov 1, 2021
Nov 1, 2021
Clinicas del Camino Real Inc-Paseo CamarilloCamarillo, CA, CCN 921181 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Nov 1, 2021
Nov 1, 2021
Clinicas del Camino Real Inc la ColoniaOxnard, CA, CCN 921908 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Nov 1, 2021
Nov 1, 2021
Clinicas del Camino Real, Inc-Roberto S Juarez Health CenterOxnard, CA, CCN A01815 Federally qualified health center Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Nov 1, 2021
Nov 1, 2021
Nov 1, 2021

Owned or controlled facilities with NPI records 16

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 16

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

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312934400000",
    "number": "1417110586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S WELLS RD # 200",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930041377",
            "telephone_number": "805-647-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S WELLS RD # 200",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930041377",
            "telephone_number": "805-647-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWAR",
        "first_name": "GAGAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2011-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A116898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.