Active NPI
Jonathan Peter Gershenson, D.O.
- Nuclear Medicine Physician
- Roseville, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nuclear Medicine Physician
- License
- 20A17270
- Practice address
- 1380 Lead Hill Blvd Ste 100
Roseville, CA 95661-2941 - Phone
- (916) 535-2030
- Fax
- (916) 536-3061
- NPI assigned
- Mar 28, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nuclear Medicine Physician | 207U00000X | 20A17270 | CA | Primary |
Addresses
Primary practice location
1380 Lead Hill Blvd Ste 100
Roseville, CA 95661-2941
Mailing address
3400 Data Dr
Rancho Cordova, CA 95670-7956
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://memorialcare.org/fhir/api/FHIR/R4/ | Health Information Exchange (HIE) | MemorialCare Medical Foundation |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nuclear Medicine
- Education
- Kansas City University of Med & Biosciences, College of Osteo Med, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2801 Atlantic Ave
Long Beach, CA 90806-1701
Phone (562) 933-1554
722 Baker St
Costa Mesa, CA 92626-4320
Phone (714) 557-6300
Hospital & facility affiliations
- Memorialcare Long Beach Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A17270 | CA | MD | Nuclear Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorialcare Medical Foundation | Current | Accepting new patients |
Locations
722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300
17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592
2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000
Interoperability endpoints
- jgershenson831676@direct.memorialcare.org
- jonathan.gershensondo.p105@direct.nautilus.nextgenshare.com
Organizations & group practices 1
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.
-
- Clinic/Center
- Fountain Valley, CA
- NPI 1205167350
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Long Beach, CA
- NPI 1962442012
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1780046847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 DATA DR",
"city": "RANCHO CORDOVA",
"state": "CA",
"postal_code": "956707956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1380 LEAD HILL BLVD STE 100",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956612941",
"telephone_number": "916-535-2030",
"fax_number": "916-536-3061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERSHENSON",
"first_name": "JONATHAN",
"middle_name": "PETER",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-28",
"last_updated": "2023-11-27",
"certification_date": "2023-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "207U00000X",
"taxonomy_group": "",
"desc": "Nuclear Medicine",
"state": "CA",
"license": "20A17270",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
"affiliation": "Y",
"endpointDescription": "MemorialCare FHIR Endpoint",
"affiliationName": "MemorialCare Medical Foundation",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "17360 Brookhurst St",
"city": "Fountain Valley",
"state": "CA",
"country_code": "US",
"postal_code": "927083720",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Roseville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.