Mary Joan D Gidor, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

C177140 Issued in CA

Practice address

50249 Cesar Chavez St Ste K
Coachella, CA 92236-1530

Phone

(760) 393-0555

Fax

(760) 393-0522

NPI assigned

Oct 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: mary.gidor.p1@direct.cdsdp.nextgenshare.com

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.

• Clinicas de Salud del Pueblo, Inc

  • Federally Qualified Health Center (FQHC)
  • El Centro, CA
  • NPI 1346313889
  Medicare reassignment NPD
• Clinicas de Salud del Pueblo Inc.

  • Federally Qualified Health Center (FQHC)
  • Hemet, CA
  • NPI 1033593108
  NPD
• Clinicas de Salud del Pueblo Inc.

  • Community/Retail Pharmacy
  • El Centro, CA
  • NPI 1962045872
  NPD
• Saint Vincent Medical Education and Research Institute Inc

  • Pediatrics Physician
  • Titusville, PA
  • NPI 1891108403
  NPD (past)

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1720277288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50249 CESAR CHAVEZ ST STE K",
            "city": "COACHELLA",
            "state": "CA",
            "postal_code": "922361530",
            "telephone_number": "760-393-0555",
            "fax_number": "760-393-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50249 CESAR CHAVEZ ST STE K",
            "city": "COACHELLA",
            "state": "CA",
            "postal_code": "922361530",
            "telephone_number": "760-393-0555",
            "fax_number": "760-393-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIDOR",
        "first_name": "MARY JOAN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-22",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME113398",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD447147",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C177140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lidia Garcia
• Pedro Garcia
• Nakisha Gardner
• Garfield Beach CVS, L.L.C.
• Michael Garispe, PHARMD
• Sergio Vincente Godinez, PA-C
• Marissa Salas Gomez
• Annacelia Gonzalez-Ramos
• Alma Elizabeth Guadarrama Hernandez
• Jose I Guerrero

• Pediatrics Physician in Coachella, CA
• Providers in Coachella, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.