Individual provider Active NPI

Zosima B Carino-Gateb, M.D.

  • Pediatric Adolescent Medicine Physician
  • Indio, CA
National Provider Identifier
1508842741
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
A45857 Issued in CA
Practice address
81833 Doctor Carreon Blvd
Suite 6
Indio, CA 92201-5590
Phone
(760) 775-7763
Fax
(760) 775-9953
NPI assigned
Dec 20, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X A45857 CA Primary

Addresses

Primary practice location

81833 Doctor Carreon Blvd
Suite 6
Indio, CA 92201-5590

Mailing address

81833 Doctor Carreon Blvd
Suite 6
Indio, CA 92201-5590
Phone (760) 775-7763

Other identifiers 2

IdentifierTypeStateIssuer
00A458571MedicaidCA
10944448OtherCACAQH PROVIDER ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A45857CAMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Zosima B. Carino-Gateb, M.D., Inc. Adolescent Medicine Past Accepting new patients
JFK Memorial Hospital, Inc. Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: zosima.carinogateb.p48@direct.mydohc.nextgenshare.com

Organizations & group practices 2

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": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1508842741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81833 DOCTOR CARREON BLVD",
            "address_2": "SUITE 6",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015590",
            "telephone_number": "760-775-7763",
            "fax_number": "760-775-9953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81833 DOCTOR CARREON BLVD",
            "address_2": "SUITE 6",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015590",
            "telephone_number": "760-775-7763",
            "fax_number": "760-775-9953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARINO-GATEB",
        "first_name": "ZOSIMA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-20",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CA",
            "license": "A45857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A458571",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "10944448",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.