Individual provider Active NPI

Robert Emerson Gardiner, M.D.

  • Psychiatry Physician
  • San Bernardino, CA
National Provider Identifier
1447326319
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G66818 Issued in CA
Practice address
5500 University Pkwy
Student Health Center
San Bernardino, CA 92407-2318
Phone
(909) 537-5241
Fax
(909) 537-7027
NPI assigned
Nov 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G66818 CA Primary

Addresses

Primary practice location

5500 University Pkwy
Student Health Center
San Bernardino, CA 92407-2318

Mailing address

504 N Farrell Dr
Palm Springs, CA 92262-6215
Phone (914) 588-9226

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
I20160715002138 CA Order and Referring Only - PsychiatryPractitioner - Psychiatry 1456389139

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G66818CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
River Valley Counseling Center, Inc PastSince Jul 19, 1994 Accepting new patients
Holyoke Medical Center, Inc. Past Accepting new patients
Holyoke Medical Center, Inc. PastSince Oct 24, 1995 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: robert.gardiner.1@3548.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1447326319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 N FARRELL DR",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922626215",
            "telephone_number": "914-588-9226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 UNIVERSITY PKWY",
            "address_2": "STUDENT HEALTH CENTER",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924072318",
            "telephone_number": "909-537-5241",
            "fax_number": "909-537-7027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDINER",
        "first_name": "ROBERT",
        "middle_name": "EMERSON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G66818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.