Individual provider Active NPI

Gita Jamshidi Kalantari, MD

  • Family Medicine Physician
  • Long Beach, CA
National Provider Identifier
1790968659
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A95847 Issued in CA
Practice address
1040 Elm Ave
Long Beach, CA 90813-3264
Phone
(562) 624-4999
NPI assigned
Dec 13, 2007
Last updated
Oct 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A95847 CA Primary

Addresses

Primary practice location

1040 Elm Ave
Long Beach, CA 90813-3264

Mailing address

1040 Elm Ave Ste 200
Long Beach, CA 90813-3266
Phone (562) 624-4999

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
I20080128000384 CA Practitioner - Family Practice 4981786118 Reassigns benefits to 1 organization

Care Compare profile

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

Practice addresses (Care Compare)

1040 Elm Ave
Suite 200
Long Beach, CA 90813-3266
Phone (652) 624-4999

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
38.53 of 100Reported as group
Quality
20.07
Promoting interoperability
0
Improvement activities
0
Cost
75.03

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95847CAMDMarriage & Family Therapist
A95847CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Partners, a Medical Group Current Accepting new patients
Prohealth Partners a Medical Group Inc CurrentSince Aug 1, 2024 Accepting new patients
Prohealth Partners, a Medical Group, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Holt Medical Corporation Past Accepting new patients
How Medical Apc Past Accepting new patients
Gita K.Medical Corp. PastSince Sep 18, 2011 Accepting new patients
Prohealth Partners, a Medical Group, Inc. Past Accepting new patients

Locations

1040 Elm Ave
Ste 200
Long Beach, CA 90813
Phone (562) 624-4999

File 54567
Los Angeles, CA 90074
Phone (310) 491-9060

Interoperability endpoints

  • Direct secure messaging: gita.kalantari.p1@direct.careclinic.nextgenshare.com

Organizations & group practices 7

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": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1790968659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 ELM AVE STE 200",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133266",
            "telephone_number": "562-624-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 ELM AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133264",
            "telephone_number": "562-624-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALANTARI",
        "first_name": "GITA",
        "middle_name": "JAMSHIDI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-13",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A95847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.