Gautam Vangipuram MD Inc

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

Legal business name

GAUTAM VANGIPURAM MD INC

Doing business as

Beach Cities Retina

Practice address

555 Pier Ave Ste D
Hermosa Beach, CA 90254-3801

Phone

(815) 342-1739

NPI assigned

Feb 23, 2023

Last updated

Feb 23, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gautam Vangipuram, MDNPI 1780052233

Title

Physician

Phone

(815) 342-1739

Specialties & licenses 1

Addresses

Other names 1

• Beach Cities Retina Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: gvangipuram@bcr.intellechartdirect.net

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gautam Vangipuram, M.D

  • Retina Specialist (Ophthalmology) Physician
  • Pasadena, CA
  • NPI 1780052233
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1677110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677110400000",
    "number": "1699474163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3565 COLONIAL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900662708",
            "telephone_number": "815-342-1739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 PIER AVE STE D",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902543801",
            "telephone_number": "815-342-1739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAUTAM VANGIPURAM MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-23",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A",
        "authorized_official_last_name": "VANGIPURAM",
        "authorized_official_first_name": "GAUTAM",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "815-342-1739",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beach Cities Retina",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Retina Specialist (Ophthalmology) Physician in Hermosa Beach, CA
• Providers in Hermosa Beach, CA by specialty
• Retina Specialist (Ophthalmology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.