Active NPI
Gopu Premrajan
- Pain Medicine Physician
- Anaheim, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine Physician
- License
- A209283
- Practice address
- 1717 E Lincoln Ave
Anaheim, CA 92805-4345 - Phone
- (714) 635-2642
- NPI assigned
- May 21, 2022
- Last updated
- Oct 7, 2026
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | A209283 | CA | |
| Pain Medicine Physician | 208VP0000X | A209283 | CA | Primary |
Addresses
Primary practice location
1717 E Lincoln Ave
Anaheim, CA 92805-4345
Mailing address
16702 Valley View Ave
La Mirada, CA 90638-5824
Phone (714) 367-5391
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- 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
- Emergency Medicine
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1 Park Ave FL
Suite 11
New York, NY 10016-5818
700 Hicksville Rd
Bethpage, NY 11714-3471
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A209283 | CA | MD | Pain Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Current | Accepting new patients | |
| New York University | Emergency Medicine | Current | Accepting new patients |
Interoperability endpoints
- gpremrajan711588@nyumc.direct-ci.com
Organizations & group practices 2
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.
-
dba NYU Faculty Group Practice
- Cardiovascular Disease Physician
- Boynton Beach, FL
- NPI 1285826438
Emergency Medicine, NY
-
dba NYU Langone Ambulatory Care Chelsea
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital Unit
- New York, NY
- NPI 1275632895
-
dba NYU Langone Hospital Long Island
- General Acute Care Hospital
- Mineola, NY
- NPI 1427616002
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1619341716
-
- General Acute Care Hospital
- New York, NY
- NPI 1669578324
-
- General Acute Care Hospital
- New York, NY
- NPI 1801992631
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1791331200000",
"number": "1881332732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16702 VALLEY VIEW AVE",
"city": "LA MIRADA",
"state": "CA",
"postal_code": "906385824",
"telephone_number": "714-367-5391",
"fax_number": "714-635-5428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 E LINCOLN AVE",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928054345",
"telephone_number": "714-635-2642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PREMRAJAN",
"first_name": "GOPU",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-21",
"last_updated": "2026-10-07",
"certification_date": "2026-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "A209283",
"primary": false
},
{
"code": "208VP0000X",
"taxonomy_group": "",
"desc": "Pain Medicine, Pain Medicine",
"state": "CA",
"license": "A209283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; 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.