Active NPI
Gustavo Ramos, P.A.-C
- Medical Physician Assistant
- Los Angeles, CA
National Provider Identifier
1669676300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA15277
- Practice address
- 400 W 30TH St
Los Angeles, CA 90007-3320 - Phone
- (213) 284-3200
- NPI assigned
- Jun 14, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA15277 | CA | Primary |
Addresses
Primary practice location
400 W 30TH St
Los Angeles, CA 90007-3320
Mailing address
30141 Antelope Rd # D-329
Menifee, CA 92584-8066
Phone (951) 227-1155
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA15277 | Medicaid | CA |
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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Primary Care Medical Group, Inc | Past | Accepting new patients | |
| University Hospital at Stony Brook | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- gustavo.ramospa.p1@direct.plannedparenthoodla.nextgenshare.com
Organizations & group practices 3
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380758400000",
"number": "1669676300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30141 ANTELOPE RD # D-329",
"city": "MENIFEE",
"state": "CA",
"postal_code": "925848066",
"telephone_number": "951-227-1155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 W 30TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900073320",
"telephone_number": "213-284-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAMOS",
"first_name": "GUSTAVO",
"credential": "P.A.-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-14",
"last_updated": "2013-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA15277",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PA15277",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.