Shubhangi Gaikwad, M.D.
Individual provider Active NPI Pediatric Emergency Medicine (Emergency Medicine) Physician · Loma Linda, CA
NPI 1447528385 · NPPES record last updated Feb 21, 2017
Key facts
- NPI
- 1447528385
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X
- License
- A128376 (CA)
- Practice address
- 11234 Anderson St
Pediatric Emergency Department
Loma Linda, CA 92354-2804 - Phone
- (909) 558-8000
- NPI assigned
- Dec 7, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cep America - California
Practice addresses (Care Compare)
420 34TH St
Bakersfield, CA 93301-2237
Phone (661) 327-1792
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160820000213 | CA | Practitioner - Pediatric Medicine |
7113212879 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A128376 | CA | MD | Pediatric Emergency Medicine (Emergency Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Faculty Physicians and Surgeons of Llusm | Current |
Accepting new patients | |
| Cep America-California | Current |
Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current |
Accepting new patients | |
| Cep America - California | Current | Accepting new patients | |
| Pinnacle Emergency Physicians of Bakersfield, a Professional Corp | Current | Accepting new patients | |
| Cep America-California | Current |
Accepting new patients | |
| Pinnacle Emergency Physicians of Bakersfield, a Professional Corp | Current |
Accepting new patients | |
| Pinnacle Emergency Physicians of Bakersfield, a Professional Corp | Current |
Accepting new patients |
Locations
420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647
2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000
11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016
11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848
File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Emergency Medicine (Emergency Medicine) Physician | 207PP0204X | A128376 | CA | Yes |
Addresses
Primary practice location
11234 Anderson St
Pediatric Emergency Department
Loma Linda, CA 92354-2804
Mailing address
11234 Anderson St
Pediatric Emergency Department
Loma Linda, CA 92354-2804
Phone (909) 558-8000
NPI Registry JSON
{
"created_epoch": "1323216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487635200000",
"number": "1447528385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11234 ANDERSON ST",
"address_2": "PEDIATRIC EMERGENCY DEPARTMENT",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923542804",
"telephone_number": "909-558-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11234 ANDERSON ST",
"address_2": "PEDIATRIC EMERGENCY DEPARTMENT",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923542804",
"telephone_number": "909-558-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAIKWAD",
"first_name": "SHUBHANGI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-07",
"last_updated": "2017-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207PP0204X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Pediatric Emergency Medicine",
"state": "CA",
"license": "A128376",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Loma Linda, CA
- Gaea, Inc
- Sharib Gaffar
- Astria Gafford
- Darryl M Gafford
- Melissa Gage
- Karen Lynn Gaio Hansberger
- Vishal Gajendran
- Youssef Galal
- Victoria Galea
- Priscilla Anahi Galindo-Salazar
All providers in Loma Linda, CA · Pediatric Emergency Medicine (Emergency Medicine) Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.