NPIMap

Individual provider Active NPI

Gisella Laverne Sandy, M.D.

  • Surgery Physician
  • Moreno Valley, CA
National Provider Identifier
1659310860
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A70697 Issued in CA
Practice address
26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone
(951) 486-4175
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X M-13674 ID
Surgery Physician 208600000X DR-50308 CO
Surgery Physician 208600000X A70697 CA Primary
Surgery Physician 208600000X M-1845 GU
Surgical Critical Care Physician 2086S0102X A70697 CA
Trauma Surgery Physician 2086S0127X A70697 CA

Addresses

Primary practice location

26520 Cactus Ave
Moreno Valley, CA 92555-3927

Mailing address

PO Box 287
Riverside, CA 92502-0287
Phone (951) 486-4175

Other practice location 1

700 W Ironwood Dr Ste 341
Coeur D Alene, ID 83814-4404
Phone (208) 625-5084

Other identifiers 3

IdentifierTypeStateIssuer
58021736MedicaidCO
00A706970OtherCABLUE SHIELD OF CALIFORNIA
00A706970MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, GU, ID3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20040823000962 CA Practitioner - General SurgeryPractitioner - Other (Physician) 7113991407 Reassigns benefits to 3 organizations
I20150615000041 GU Practitioner - General Surgery 7113991407 Reassigns benefits to 1 organization
I20230906000853 ID Practitioner - General Surgery 7113991407 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Loma Linda University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kootenai Health IncGroup PAC ID 1355792276, 394 clinicians
Siskiyou Hospital IncGroup PAC ID 1254223134, 96 clinicians

Practice addresses (Care Compare)

1055 Riverside Ave
Orofino, ID 83544-9029
Phone (208) 476-5777

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051

444 Bruce St
Yreka, CA 96097-3450
Phone (530) 842-4121

Hospital & facility affiliations

  • Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049
  • Fairchild Medical Center Hospital, Yreka, CA, CCN 051316
  • Mercy Regional Medical Center Hospital, Durango, CO, CCN 060013

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A70697CAMDSurgery Physician
DR-50308COMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General Conference Corp of Sda CurrentSince Mar 1, 2015 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Kootenai Health, Inc. CurrentSince Jul 23, 2023 Accepting new patients
Kootenai Health, Inc. Surgery Current Accepting new patients
Kern County Hospital Authority CurrentSince Apr 2, 2018 Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Kootenai Health, Inc. CurrentSince Jul 23, 2023 Accepting new patients
Kern County Hospital Authority CurrentSince Apr 2, 2018 Accepting new patients
Incyte Pathology, PLLC Current Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Mission Surgical Clinic, Inc. Surgery Past Accepting new patients
Lander Valley Physician Practices, LLC Past Accepting new patients
Zakhireh Inc Surgery Past Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

1700 Mount Vernon Ave
Rm 1241
Bakersfield, CA 93306
Phone (661) 326-2220

1700 Mount Vernon Ave
Bakersfield, CA 93306
Phone (616) 326-2000

700 W Ironwood Dr
Ste 341
Coeur D Alene, ID 83814
Phone (208) 625-5200

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

1300 E Mullan Ave
Ste 1300
Post Falls, ID 83854
Phone (208) 625-5630

1300 E Mullan Ave
Ste 700
Post Falls, ID 83854
Phone (208) 625-5564

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1659310860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 287",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925020287",
            "telephone_number": "951-486-4175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26520 CACTUS AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925553927",
            "telephone_number": "951-486-4175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 W Ironwood Dr Ste 341",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838144404",
            "country_code": "US",
            "telephone_number": "208-625-5084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDY",
        "first_name": "GISELLA",
        "middle_name": "LAVERNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "M-13674",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "DR-50308",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A70697",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GU",
            "license": "M-1845",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CA",
            "license": "A70697",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "CA",
            "license": "A70697",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58021736",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "00A706970",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A706970",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.