Individual provider Active NPI

Sanjiv Jaysing Ghogale, M.D.

  • Anesthesiology Physician
  • San Diego, CA
National Provider Identifier
1740248566
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
55247 Issued in CA
Practice address
34800 Bob Wilson Dr
Nmcsd: Department of Anesthesia
San Diego, CA 92134-1098
Phone
(619) 532-8943
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 40900-020 WI
Anesthesiology Physician 207L00000X 55247 CA Primary

Addresses

Primary practice location

34800 Bob Wilson Dr
Nmcsd: Department of Anesthesia
San Diego, CA 92134-1098

Mailing address

34800 Bob Wilson Dr
Nmcsd: Department of Anesthesia
San Diego, CA 92134-1098
Phone (619) 532-8943

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20130102000282 CA Practitioner - Anesthesiology 1153574926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3430 E la Palma Ave
Anaheim, CA 92806-2020
Phone (888) 988-2800

3460 E la Palma Ave
Anaheim, CA 92806-2020
Phone (714) 644-2010

5475 E la Palma Ave
Anaheim, CA 92807-2075
Phone (714) 279-6088

6640 Alton Pkwy
Irvine, CA 92618-3734
Phone (949) 932-5000

6650 Alton Pkwy
Irvine, CA 92618-3734
Phone (949) 932-5000

6670 Alton Pkwy
Irvine, CA 92618-3734
Phone (949) 932-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55247CAMDMarriage & Family Therapist
40900-020WIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Nov 12, 2012 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 12, 2012 Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1740248566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "address_2": "NMCSD: DEPARTMENT OF ANESTHESIA",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098",
            "telephone_number": "619-532-8943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "address_2": "NMCSD: DEPARTMENT OF ANESTHESIA",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098",
            "telephone_number": "619-532-8943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOGALE",
        "first_name": "SANJIV",
        "middle_name": "JAYSING",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "40900-020",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "55247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.