NPIMap

Organization Active NPI

Advanced Gi Consultants Medical Group, Inc.

  • Gastroenterology Physician
  • Burbank, CA
National Provider Identifier
1558448795
Registry record updated Sep 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A72217 Issued in CA
Legal business name
ADVANCED GI CONSULTANTS MEDICAL GROUP, INC.
Practice address
4314 W Victory Blvd
Burbank, CA 91505-1334
Phone
(818) 845-1854
Fax
(626) 289-5686
NPI assigned
Nov 1, 2006
Last updated
Sep 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2012

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

Authorized official

Name
Dr. Yeong an Sheu, M.D.NPI 1700865177
Title
President
Phone
(818) 399-0556

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A72217 CA
Gastroenterology Physician 207RG0100X A72217 CA Primary

Addresses

Primary practice location

4314 W Victory Blvd
Burbank, CA 91505-1334

Mailing address

4314 W Victory Blvd
Burbank, CA 91505-1334
Phone (818) 845-1854

Other identifiers 1

IdentifierTypeStateIssuer
00A722170MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050404001096 CA Part B Supplier - Clinic/Group Practice 6507813300 Receives reassigned benefits from 1 practitioner
Practice locations: Burbank, CA

National Provider Directory

National Provider Directory
Tax ID family
Advanced Gi Consultants2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347926400000",
    "number": "1558448795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4314 W VICTORY BLVD",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915051334",
            "telephone_number": "818-845-1854",
            "fax_number": "626-289-5686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4314 W VICTORY BLVD",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915051334",
            "telephone_number": "818-845-1854",
            "fax_number": "626-289-5686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED GI CONSULTANTS MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-09-18",
        "status": "A",
        "authorized_official_last_name": "SHEU",
        "authorized_official_first_name": "YEONG AN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-399-0556",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A72217",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A72217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A722170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.