Individual provider Active NPI

Michael Allen Gertz, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Los Angeles, CA
National Provider Identifier
1720021173
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
A67874 Issued in CA
Practice address
757 Westwood PLZ
RM 14 19
Los Angeles, CA 90095-3075
Phone
(310) 825-2111
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Preventive Medicine) Physician 2083A0300X A67874 CA
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X A67874 CA Primary

Addresses

Primary practice location

757 Westwood PLZ
RM 14 19
Los Angeles, CA 90095-3075

Mailing address

5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631
Phone (310) 825-2111

Other identifiers 1

IdentifierTypeStateIssuer
00A678740MedicaidCA

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
I20031201000848 CA Practitioner - Emergency Medicine 8628973849 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.53 of 100Reported as group
Quality
85.33
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A67874CAMDAddiction Medicine (Preventive Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Los Robles Emergency Physicians Medical Group CurrentSince Jan 1, 2016 Accepting new patients
Antelope Valley Emergency Medical Associates Inc CurrentSince Apr 1, 2005 Accepting new patients
Columbia Emergency Medical Group Inc Past Accepting new patients
UCLA Medical Group Past Accepting new patients

Locations

1600 W Avenue J
Lancaster, CA 93534
Phone (661) 726-6254

215 W Janss Rd
Thousand Oaks, CA 91360
Phone (805) 379-5435

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1720021173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-825-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ",
            "address_2": "RM 14 19",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953075",
            "telephone_number": "310-825-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERTZ",
        "first_name": "MICHAEL",
        "middle_name": "ALLEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "CA",
            "license": "A67874",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "CA",
            "license": "A67874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A678740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.