Individual provider Active NPI

Gerald Neil Schaffer, MD

  • Gastroenterology Physician
  • San Pablo, CA
National Provider Identifier
1780797027
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G39171 Issued in CA
Practice address
2089 Vale Rd
Suite 33
San Pablo, CA 94806-3847
Phone
(510) 234-5012
Fax
(510) 234-4921
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X G39171 CA Primary

Addresses

Primary practice location

2089 Vale Rd
Suite 33
San Pablo, CA 94806-3847

Mailing address

2089 Vale Rd
Suite 33
San Pablo, CA 94806-3847
Phone (510) 234-5012

Other identifiers 1

IdentifierTypeStateIssuer
GR0025670MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G39171CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Digestive Disorders Gastroenterology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: gschaffer958390@directa.mercy.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375228800000",
    "number": "1780797027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2089 VALE RD",
            "address_2": "SUITE 33",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063847",
            "telephone_number": "510-234-5012",
            "fax_number": "510-234-4921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2089 VALE RD",
            "address_2": "SUITE 33",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063847",
            "telephone_number": "510-234-5012",
            "fax_number": "510-234-4921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAFFER",
        "first_name": "GERALD",
        "middle_name": "NEIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2013-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G39171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0025670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pablo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.