Individual provider Active NPI

Miranda Pwen Gaw, MD

  • Internal Medicine Physician
  • Lancaster, CA
National Provider Identifier
1891705885
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A52438 Issued in CA
Practice address
1669 W Avenue J Ste 304
Lancaster, CA 93534-2870
Phone
(661) 951-7888
Fax
(661) 951-8889
NPI assigned
Aug 9, 2006
Reactivated
Sep 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A52438 CA Primary

Addresses

Primary practice location

1669 W Avenue J Ste 304
Lancaster, CA 93534-2870

Mailing address

1669 W Ave J, Suite 304
Lancaster, CA 93534
Phone (661) 951-7888

Other identifiers 1

IdentifierTypeStateIssuer
00A524380MedicaidCA

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
I20151215002117 CA Practitioner - Internal Medicine 3375507825 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52438CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Brian K Gaw, M.D., Inc. CurrentSince Jun 19, 2014 Accepting new patients
Morgan-Haugh Professional Services Corporation Past Accepting new patients
Oncology Hematology Consultants, PSC Past Accepting new patients

Locations

1669 W Avenue J
Ste 304
Lancaster, CA 93534
Phone (661) 951-7888

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1891705885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1669 W AVE J, SUITE 304",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "93534",
            "telephone_number": "661-951-7888",
            "fax_number": "661-951-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 W AVENUE J STE 304",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342870",
            "telephone_number": "661-951-7888",
            "fax_number": "661-951-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAW",
        "first_name": "MIRANDA",
        "middle_name": "PWEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2014-06-24",
        "deactivation_date": "2006-08-22",
        "reactivation_date": "2006-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A52438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A524380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.