Gustavo Lara, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A77165 Issued in CA

Practice address

7111 Indiana Ave Ste 100
Riverside, CA 92504

Phone

(951) 276-9012

Fax

(951) 276-9163

NPI assigned

Apr 11, 2006

Last updated

May 24, 2018By 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

Other identifiers 1

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

Specialty

General Surgery

Education

Harvard Medical School, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nurick Surgical Institute IncGroup PAC ID 2961426630, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside Community Hospital Hospital, Riverside, CA, CCN 050022
• Parkview Community Hospital Medical Center Hospital, Riverside, CA, CCN 050102

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: gla103pcs@m1401.primeclinicalsystems.direct-ci.com

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.

• Nurick Surgical Institute Inc

  • Surgery Physician
  • Riverside, CA
  • NPI 1770659278
  Medicare reassignment Care Compare group NPD
• Doctors Hospital of Riverside LLC

  dba Parkview Community Hospital Medical Center

  • General Acute Care Hospital
  • Riverside, CA
  • NPI 1124596382
  NPD (past)
• Riverside Healthcare System, L.P.

  dba Riverside Community Hospital

  • Rehabilitation Hospital Unit
  • Riverside, CA
  • NPI 1053358010
  NPD (past)

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

• Doctors Hospital of Riverside LLC

  dba Parkview Community Hospital Medical Center

  • General Acute Care Hospital
  • Riverside, CA
  • NPI 1124596382
  Care Compare affiliation
• Riverside Healthcare System, L.P.

  dba Riverside Community Hospital

  • General Acute Care Hospital
  • Riverside, CA
  • NPI 1114971660
  Care Compare affiliation

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1639132392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 INDIANA AVE STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925044557",
            "telephone_number": "951-276-9012",
            "fax_number": "951-276-9163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7111 INDIANA AVE STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92504",
            "telephone_number": "951-276-9012",
            "fax_number": "951-276-9163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARA",
        "first_name": "GUSTAVO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A77165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A771650",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Viviana Lara-Kovachev
• Alma Fabiola Lara
• Anais Lara
• Andrea Lara
• Daniel Lara
• Jennifer Lara
• Paola Lara
• Ava Marin Lardizabal
• River Lares
• Sarra Larif, MD

• Surgery Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.