Individual provider Active NPI

Jeffrey Todd Gerton, MD

  • Emergency Medicine Physician
  • Kealakekua, HI
National Provider Identifier
1689719494
Registry record updated Apr 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD - 16402 Issued in HI
Practice address
79-1019 Haukapila St
Emergency Department
Kealakekua, HI 96750-7920
Phone
(808) 322-4413
NPI assigned
Feb 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X D69032 MD
Emergency Medicine Physician 207P00000X MD - 16402 HI Primary

Addresses

Primary practice location

79-1019 Haukapila St
Emergency Department
Kealakekua, HI 96750-7920

Mailing address

79-1019 Haukapila St
Emergency Department
Kealakekua, HI 96750-7920
Phone (808) 322-4413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170722000153 TX Practitioner - Emergency Medicine 8921146309 Reassigns benefits to 1 organization
I20180222002957 WA Practitioner - Emergency Medicine 8921146309 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Ohio State University College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Washington Emergency Physicians PLLCGroup PAC ID 0749514735, 78 clinicians
Mt Rainier Emergency Physicians PLLCGroup PAC ID 7810980968, 25 clinicians

Practice addresses (Care Compare)

14815 Pacific Ave S
Tacoma, WA 98444-4654
Phone (253) 697-8660

401 15TH Ave SE
Puyallup, WA 98372-3715
Phone (253) 697-1848

Hospital & facility affiliations

  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD - 16402HIMDEmergency Medicine Physician
D69032MDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mt. Rainier Emergency Physicians, PLLC Emergency Medicine CurrentSince Mar 9, 2018 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Aug 2, 2017 Accepting new patients
Upper Chesapeake Emergency Medicine Physicians, LLC Emergency Medicine Past Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

401 15th Ave SE
Puyallup, WA 98372
Phone (253) 697-1848

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334534400000",
    "number": "1689719494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79-1019 HAUKAPILA ST",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "KEALAKEKUA",
            "state": "HI",
            "postal_code": "967507920",
            "telephone_number": "808-322-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79-1019 HAUKAPILA ST",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "KEALAKEKUA",
            "state": "HI",
            "postal_code": "967507920",
            "telephone_number": "808-322-4413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERTON",
        "first_name": "JEFFREY",
        "middle_name": "TODD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2012-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D69032",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": "MD - 16402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kealakekua, HI

Sources for this page

Verify at the official NPI Registry.