Individual provider Active NPI

Gloria Michelle Ventura, M.D.

  • Family Medicine Physician
  • Perris, CA
National Provider Identifier
1689094757
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A144192 Issued in CA
Practice address
1675 N Perris Blvd Ste G1
Perris, CA 92571-4748
Phone
(951) 956-2400
Fax
(951) 956-2345
NPI assigned
Apr 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A144192 CA Primary

Addresses

Primary practice location

1675 N Perris Blvd Ste G1
Perris, CA 92571-4748

Mailing address

1675 N Perris Blvd Ste G1
Perris, CA 92571-4748
Phone (951) 956-2400

Other identifiers 1

IdentifierTypeStateIssuer
1689094757OtherINDIVIDUAL

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: 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
I20170912000591 CA Practitioner - Family PracticePractitioner - Other (Physician) 2264705300 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

10800 Magnolia Ave
Riverside, CA 92505-3043
Phone (951) 353-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A144192CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince May 28, 2024 Accepting new patients
County of Riverside CurrentSince Jul 1, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince May 28, 2024 Accepting new patients
Neighborhood Healthcare CurrentSince Jan 7, 2019 Accepting new patients
County of Riverside CurrentSince Jul 1, 2023 Accepting new patients
Neighborhood Healthcare CurrentSince Jan 7, 2019 Accepting new patients

Locations

425 N Date St
Escondido, CA 92025
Phone (760) 737-2035

2499 E Lakeshore Dr
Lake Elsinore, CA 92530
Phone (951) 471-4200

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

308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700

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

41840 Enterprise Cir N
Temecula, CA 92590
Phone (951) 225-6400

Interoperability endpoints

  • Direct secure messaging: gventura72574@direct.llu.edu

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1689094757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 N PERRIS BLVD STE G1",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925714748",
            "telephone_number": "951-956-2400",
            "fax_number": "951-956-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 N PERRIS BLVD STE G1",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925714748",
            "telephone_number": "951-956-2400",
            "fax_number": "951-956-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTURA",
        "first_name": "GLORIA",
        "middle_name": "MICHELLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-16",
        "last_updated": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A144192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL",
            "identifier": "1689094757",
            "state": null
        }
    ],
    "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": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Perris, CA

Sources for this page

Verify at the official NPI Registry.