Active NPI
Gary Mishkin, M.D.
- Family Medicine Physician
- Saint Helena, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G56321
- Practice address
- 10 Woodland Rd
Saint Helena, CA 94574-9554 - Phone
- (707) 963-3611
- NPI assigned
- Nov 30, 2005
- Last updated
- Mar 13, 2024
- 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 | CAG056321 | CA | |
| Family Medicine Physician | 207Q00000X | G56321 | CA | Primary |
Addresses
Primary practice location
10 Woodland Rd
Saint Helena, CA 94574-9554
Mailing address
10 Woodland Rd
Saint Helena, CA 94574-9554
Phone (707) 963-3611
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CAG056321 | Other | CA | STATE LICENSE NUMBER |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CAG056321 | CA | MD | Emergency Medicine Physician |
| G56321 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chase Dennis Emergency Medical Group Inc | Emergency Medicine | Current | Accepting new patients |
| Providence Medical Foundation | Current | Accepting new patients | |
| Norcal Healthconnect LLC | Current | Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Family Medicine | Current | Accepting new patients |
| Norcal Healthconnect LLC | Current | Accepting new patients | |
| Norcal Healthconnect LLC | Current | Accepting new patients | |
| St. Joseph Health Northern California, LLC | Past | Accepting new patients | |
| Queen of the Valley Medical Association | Past | Accepting new patients |
Locations
1375 University St
Healdsburg, CA 95448
Phone (707) 385-2025
110 Lynch Creek Way
#B
Petaluma, CA 94954
Phone (707) 522-4348
1450 Medical Center Dr
Rohnert Park, CA 94928
Phone (707) 546-3210
1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300
1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210
500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842
501 Petaluma Ave
Sebastopol, CA 95472
Phone (707) 823-8511
Interoperability endpoints
- gmishkin@yourcarecommunity.org
Organizations & group practices 10
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.
-
- Emergency Medicine Physician
- Santa Rosa, CA
- NPI 1033152350
-
- Multi-Specialty Clinic/Center
- Healdsburg, CA
- NPI 1720695547
-
- Family Medicine Physician
- Brea, CA
- NPI 1871607762
-
dba Petaluma Valley Hospital
- General Acute Care Hospital
- Petaluma, CA
- NPI 1235162645
-
dba Healdsburg Hospital
- Critical Access Hospital
- Healdsburg, CA
- NPI 1861009672
-
- Obstetrics & Gynecology Physician
- Napa, CA
- NPI 1205131950
-
- General Practice Physician
- Diamond Bar, CA
- NPI 1285890624
-
- Family Medicine Physician
- Anaheim, CA
- NPI 1639715709
-
dba St Joseph Heritage Health System
- Gynecology Physician
- Napa, CA
- NPI 1649260126
-
dba Providence Santa Rosa Memorial Hospital
- General Acute Care Hospital
- Santa Rosa, CA
- NPI 1134152549
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710288000000",
"number": "1912981382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 WOODLAND RD",
"city": "SAINT HELENA",
"state": "CA",
"postal_code": "945749554",
"telephone_number": "707-963-3611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 WOODLAND RD",
"city": "SAINT HELENA",
"state": "CA",
"postal_code": "945749554",
"telephone_number": "707-963-3611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISHKIN",
"first_name": "GARY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-30",
"last_updated": "2024-03-13",
"certification_date": "2024-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "CAG056321",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G56321",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "CAG056321",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Helena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.