Individual provider Active NPI

Anthony Gregory II

  • Glaucoma Specialist (Ophthalmology) Physician
  • San Bernardino, CA
National Provider Identifier
1467784389
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Glaucoma Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0009X
License
A140370 Issued in CA
Practice address
399 E Highland Ave Ste 401
San Bernardino, CA 92404-3862
Phone
(909) 327-3118
Fax
(909) 327-3119
NPI assigned
Feb 2, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 073956 GA
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X A140370 CA Primary

Addresses

Primary practice location

399 E Highland Ave Ste 401
San Bernardino, CA 92404-3862

Mailing address

2619 E Colorado Blvd # 150
Pasadena, CA 91107-3747
Phone (678) 643-8633

Other practice location 1

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (678) 463-8633

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20160727000444 CA Practitioner - Ophthalmology 4981914553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Johns Hopkins University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

20000 Rinaldi St
Porter Ranch, CA 91326-4900
Phone (877) 608-0044

5601 De Soto Ave
Woodland Hills, CA 91367-6701
Phone (818) 719-2000

Hospital & facility affiliations

  • Kaiser Foundation Hospital - Woodland Hills Hospital, Woodland Hills, CA, CCN 050677

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A140370CAMDGlaucoma Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 23, 2018 Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 23, 2018 Accepting new patients

Locations

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

399 E Highland Ave
Ste 401
Sn Bernrdno, CA 92404
Phone (909) 327-3118

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

Interoperability endpoints

  • Direct secure messaging: agregory1358557@direct.uclahealth.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1467784389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2619 E COLORADO BLVD # 150",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073747",
            "telephone_number": "678-643-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 E HIGHLAND AVE STE 401",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043862",
            "telephone_number": "909-327-3118",
            "fax_number": "909-327-3119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1365 Clifton Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221013",
            "country_code": "US",
            "telephone_number": "678-463-8633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "ANTHONY",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-02",
        "last_updated": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "073956",
            "primary": false
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "CA",
            "license": "A140370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5601 De Soto Ave",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913676701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.