Organization Active NPI

Gold Standard Urology

Doing business as Gold Standard Urology Medical Group

  • Urology Physician
  • Los Angeles, CA
National Provider Identifier
1417211533
Registry record updated Jul 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A100321 Issued in CA
Legal business name
GOLD STANDARD UROLOGY
Doing business as
Gold Standard Urology Medical Group
Practice address
617 W Manchester Ave
Los Angeles, CA 90044-5718
Phone
(213) 750-7675
Fax
(888) 534-5766
NPI assigned
Jul 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2012

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

Authorized official

Name
Dr. Dana Nicole Scott, M.D.NPI 1114109626
Title
President
Phone
(213) 750-7675

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X A100321 CA
Urology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208800000X A100321 CA Primary

Addresses

Primary practice location

617 W Manchester Ave
Los Angeles, CA 90044-5718

Mailing address

4859 W Slauson Ave
#305
Los Angeles, CA 90056-1290
Phone (213) 750-7675

Other names 1

  • Gold Standard Urology Medical Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130404000321 CA Part B Supplier - Clinic/Group Practice 3779728258 Receives reassigned benefits from 1 practitioner
Practice locations: Van Nuys, CA; Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

4859 W Slauson Ave
#305
Los Angeles, CA 90056
Phone (323) 846-4265

4859 W Slauson Ave
Ste 305
Los Angeles, CA 90056

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)…

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341273600000",
    "number": "1417211533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4859 W SLAUSON AVE",
            "address_2": "#305",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900561290",
            "telephone_number": "213-750-7675",
            "fax_number": "888-534-5766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 W MANCHESTER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900445718",
            "telephone_number": "213-750-7675",
            "fax_number": "888-534-5766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD STANDARD UROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-03",
        "last_updated": "2012-07-03",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-750-7675",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "A100321",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "A100321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gold Standard Urology Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; 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.