Individual provider Active NPI

Gourab Das

  • Physician Assistant
  • Encinitas, CA
National Provider Identifier
1487066965
Registry record updated Jun 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA51621 Issued in CA
Practice address
477 N El Camino Real
Suite # A200
Encinitas, CA 92024-1328
Phone
(760) 942-1242
NPI assigned
Jun 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA51621 CA Primary

Addresses

Primary practice location

477 N El Camino Real
Suite # A200
Encinitas, CA 92024-1328

Mailing address

477 N El Camino Real
Suite # A200
Encinitas, CA 92024-1328
Phone (760) 942-1242

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140829000016 CA Practitioner - Physician Assistant 5395963524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Stanford University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Monica Perlman MD IncGroup PAC ID 8820035884, 357 clinicians

Practice addresses (Care Compare)

3737 Moraga Ave
Suite B103
San Diego, CA 92117-5352
Phone (858) 799-0855

3900 5TH Ave
Suite 110
San Diego, CA 92103-3122
Phone (858) 554-1212

477 N El Camino Real
Suite A200
Encinitas, CA 92024-1350
Phone (858) 766-6007

Hospital & facility affiliations

  • Sea Coast Home Health Care Inc Home health agency, San Diego, CA, CCN 559055
  • UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital, San Diego, CA, CCN 050025
  • Scripps Memorial Hospital - Encinitas Hospital, Encinitas, CA, CCN 050503

Merit-based Incentive Payment System (MIPS)

Final score
92.17 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
73.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA51621CAMDPhysician Assistant

Practice roles (2 of 3)

OrganizationSpecialtyStatusNew patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients
Regents of the University of California Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 3

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": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401667200000",
    "number": "1487066965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL",
            "address_2": "SUITE # A200",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241328",
            "telephone_number": "760-942-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL",
            "address_2": "SUITE # A200",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241328",
            "telephone_number": "760-942-1242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAS",
        "first_name": "GOURAB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-02",
        "last_updated": "2014-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA51621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.