NPIMap

Individual provider Active NPI

Ariel Monsanto Gavino, M.D.

  • Addiction Psychiatry Physician
  • Anaheim, CA
National Provider Identifier
1659531994
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Psychiatry PhysicianTaxonomy code 2084P0802X
License
A 118822 Issued in CA
Practice address
1673 W Broadway Ste 6
Anaheim, CA 92802-1109
Phone
(714) 774-5915
Fax
(714) 774-8095
NPI assigned
Jun 10, 2008
Last updated
Jun 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA 15737 CA
Addiction Psychiatry Physician 2084P0802X A 118822 CA Primary
Certified Respiratory Therapist 227800000X RCP 18139 CA

Addresses

Primary practice location

1673 W Broadway Ste 6
Anaheim, CA 92802-1109

Mailing address

PO Box 291307
Los Angeles, CA 90029-9307
Phone (480) 703-2328

Other practice location 1

1505 N Edgemont St Fl 3
Los Angeles, CA 90027-5209
Phone (323) 783-8206

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
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140827002829 CA Practitioner - PsychiatryPractitioner - Addiction Medicine 8921169004 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ariel Gavino MD a Medical CorporationGroup PAC ID 2365898525, 2 clinicians

Practice addresses (Care Compare)

6440 Bellingham Ave
Suite 2
N Hollywood, CA 91606-1402
Phone (818) 860-4330

8065 Webb Ave
Suite a
N Hollywood, CA 91605-1505

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue161

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A 118822CAMDAddiction Psychiatry Physician
RCP 18139CAMDCertified Respiratory Therapist
PA 15737CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
JWCH Institute Inc CurrentSince Jan 22, 2021 Accepting new patients
Ariel Gavino M.D. a Medical Corporation CurrentSince Aug 30, 2023 Accepting new patients
JWCH Institute, Inc. CurrentSince Jan 22, 2021 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 24, 2014 Accepting new patients
JWCH Institute Inc Current Accepting new patients
Aungkhin Psychiatry Medical Group Inc CurrentSince Jul 3, 2022 Accepting new patients
Aungkhin Psychiatry Medical Group PastSince Jul 3, 2022 Accepting new patients

Locations

5650 Jillson St
Commerce, CA 90040
Phone (213) 484-1186

954 N Vermont Ave
Los Angeles, CA 90029
Phone (323) 454-4850

6440 Bellingham Ave
Ste 2
North Hollywood, CA 91606
Phone (626) 593-8131

12360 Firestone Blvd
Norwalk, CA 90650
Phone (562) 281-0305

1845 N Fair Oaks Ave
Ste G151
Pasadena, CA 91103
Phone (626) 744-6140

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

Interoperability endpoints

  • Direct secure messaging: ariel.gavinomdpsy.p1@direct.jwch.nextgenshare.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/AJHCDD/Endpoint/AJHCDD

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1659531994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 291307",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900299307",
            "telephone_number": "480-703-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1673 W BROADWAY STE 6",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928021109",
            "telephone_number": "714-774-5915",
            "fax_number": "714-774-8095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1505 N Edgemont St Fl 3",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900275209",
            "country_code": "US",
            "telephone_number": "323-783-8206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAVINO",
        "first_name": "ARIEL",
        "middle_name": "MONSANTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-10",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA 15737",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "CA",
            "license": "A 118822",
            "primary": true
        },
        {
            "code": "227800000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Certified",
            "state": "CA",
            "license": "RCP 18139",
            "primary": false
        }
    ],
    "identifiers": [],
    "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": "4760 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.