Gloria Jane Stevens, M.D.

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

G058338 Issued in CA

Practice address

954 W Foothill Blvd Ste B
Upland, CA 91786

Phone

(909) 949-7500

Fax

(909) 946-1133

NPI assigned

Dec 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 9

Other names 1

• Dr. Gloria Jane Liskanich Other name

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

Specialty

Dermatology

Education

Wayne State University School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

J Robert West MD IncGroup PAC ID 8729990973, 141 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099
• Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231

Merit-based Incentive Payment System (MIPS)

Final score

85.17 of 100Reported as group

Quality

74.51

Promoting interoperability

92

Improvement activities

40

Cost

82.72

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: gloria.stevens@westderm.emadirect.md
• Direct secure messaging: casacolina@direct.casacolina.org

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.

• J Robert West, M.D., Inc

  dba Southern California Dermatology

  • Dermatology Physician
  • Newport Beach, CA
  • NPI 1932154788
  Medicare reassignment Care Compare group NPD
• Casa Colina Hospital and Centers for Healthcare

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1952777245
  NPD
• San Antonio Regional Hospital

  • General Acute Care Hospital
  • Upland, CA
  • NPI 1780681189
  NPD (past)
• J. Robert West, M.D., Inc

  dba West Dermatology

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1114567997
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pomona Valley Hospital Medical Center

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1407813660
  Care Compare affiliation
• San Antonio Regional Hospital

  • General Acute Care Hospital
  • Upland, CA
  • NPI 1780681189
  Care Compare affiliation

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539820800000",
    "number": "1699836288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "954 W FOOTHILL BLVD STE B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863782",
            "telephone_number": "909-949-7500",
            "fax_number": "909-946-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 W FOOTHILL BLVD STE B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "91786",
            "telephone_number": "909-949-7500",
            "fax_number": "909-946-1133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "954 W Foothill Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "91786",
            "country_code": "US",
            "telephone_number": "909-949-7500",
            "fax_number": "909-946-1133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "GLORIA",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2018-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "G058338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCN",
            "identifier": "330357267",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRI CARE",
            "identifier": "330357267",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "330357267",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "330357267",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "330357267",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHEILD",
            "identifier": "330357267",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "330357267",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE",
            "identifier": "330357267",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8357422",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLORIA",
            "last_name": "LISKANICH",
            "middle_name": "JANE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Steve Chu, D.D.S., Inc.
• Steven Chow MD Inc
• Steven L. Chiu, D.D.S., Inc.
• Betty Marie Stevens, M.F.T.
• Bryan M. Stevens, D.D.S.
• Walter E Stevens Jr., M.D.
• Bernadette Steverson, ARDMS
• Stewart Wang MD Inc
• Thurma Stewart, LMFT
• Sean D Stitt, AMFT

• Procedural Dermatology Physician in Upland, CA
• Providers in Upland, CA by specialty
• Procedural Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.