NPIMap

Organization Active NPI

New Age Gastroenterology, Inc.

  • Gastroenterology Physician
  • San Bernardino, CA
National Provider Identifier
1861956971
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
NEW AGE GASTROENTEROLOGY, INC.
Practice address
245 E Redlands Blvd Ste K
San Bernardino, CA 92408-3760
Phone
(909) 654-2199
Fax
(909) 798-8765
NPI assigned
Jan 23, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Authorized official

Name
Keisha L Baldeosingh, M.D.NPI 1689994329
Title
President
Phone
(909) 654-2199

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X
Gastroenterology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

245 E Redlands Blvd Ste K
San Bernardino, CA 92408-3760

Mailing address

PO Box 8126
Redlands, CA 92375-1326
Phone (909) 654-2199

National Provider Directory

National Provider Directory

Locations

245 E Redlands Blvd
Ste K
San Bernardino, CA 92408
Phone (909) 654-2199

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1861956971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8126",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923751326",
            "telephone_number": "909-654-2199",
            "fax_number": "909-798-8765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 E REDLANDS BLVD STE K",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083760",
            "telephone_number": "909-654-2199",
            "fax_number": "909-798-8765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW AGE GASTROENTEROLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "BALDEOSINGH",
        "authorized_official_first_name": "KEISHA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-654-2199",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.