Brian Randall Gantwerker, M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

A109316 Issued in CA

Practice address

2811 Wilshire Blvd
Suite 840
Santa Monica, CA 90403-4803

Phone

(310) 694-8300

Fax

(310) 694-8357

NPI assigned

Feb 28, 2006

Last updated

Jun 14, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 2, 2023 through Jan 2, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brian R. Gantwerker, M.D., a Medical Corporation

  dba The Craniospinal Center of Los Angeles

  • Neurological Surgery Physician
  • Santa Monica, CA
  • NPI 1639475759
  Authorized official Same address or phone
• Neurosurgical Associates, LTD

  dba Barrow Brain and Spine

  • Neurological Surgery Physician
  • Phoenix, AZ
  • NPI 1043202484
  NPD (past)

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1609842715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 492209",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900492209",
            "telephone_number": "310-694-8300",
            "fax_number": "310-694-8357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD",
            "address_2": "SUITE 840",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034803",
            "telephone_number": "310-694-8300",
            "fax_number": "310-694-8357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANTWERKER",
        "first_name": "BRIAN",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A109316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farinoush Gaminchi, D.M.D.
• Vipal Dinesh Gandhi, O.D.
• Roshen Ganesh, D.D.S.
• Kiran Gangadhar, MD
• Shahrouz Daniel Ganjian, MD
• Yuqing Alexandria Gao, M.D.
• Alison C Garb
• Stuart H. Garber, D.C., PH.D.
• Mary Garbesi, MFT
• Rodrigo Enrique Garcia Tome, M.D.

• Neurological Surgery Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Neurological Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.