Individual provider Active NPI

Bruce T Gipe, MD

  • Pulmonary Disease Physician
  • Fallbrook, CA
National Provider Identifier
1639134877
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
G42382 Issued in CA
Practice address
624 E Elder St
Fallbrook, CA 92028-3004
Phone
(760) 728-1191
NPI assigned
Apr 19, 2006
Last updated
Dec 1, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G42382 CA
Internal Medicine Physician 207R00000X G42382 CA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X G42382 CA
Pulmonary Disease Physician 207RP1001X G42382 CA Primary

Addresses

Primary practice location

624 E Elder St
Fallbrook, CA 92028-3004

Mailing address

PO Box 998
North Hollywood, CA 91603-0998
Phone (818) 509-2222

Other identifiers 1

IdentifierTypeStateIssuer
00G423820MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050818001137 CA Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Emergency Medicine 2769389725 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G42382CAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chase Dennis Emergency Medical Group Inc Emergency Medicine CurrentSince Oct 8, 2014 Accepting new patients
Clinic Services of California Medical Group Inc Emergency Medicine CurrentSince Aug 1, 2018 Accepting new patients
Rancho Faculty Medical Associates, Inc. Past Accepting new patients

Locations

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1400

1415 Ross Ave
El Centro, CA 92243
Phone (760) 339-4045

624 E Elder St
Fallbrook, CA 92028
Phone (760) 451-4165

1235 W Vine St
Ste 20
Lodi, CA 95240
Phone (209) 339-7600

Interoperability endpoints

  • Direct secure messaging: bgipe17824@armc.direct.summit-healthcare.org

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322697600000",
    "number": "1639134877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 998",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916030998",
            "telephone_number": "818-509-2222",
            "fax_number": "818-761-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 E ELDER ST",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920283004",
            "telephone_number": "760-728-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIPE",
        "first_name": "BRUCE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2011-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G42382",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G42382",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "G42382",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "G42382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G423820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fallbrook, CA

Sources for this page

Verify at the official NPI Registry.