Gary Proffett, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A31780 Issued in CA

Practice address

46 Calle del Norte
Rancho Mirage, CA 92270-5210

Phone

(805) 658-2552

NPI assigned

Jan 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Luis M Blando MD Inc

  • Family Medicine Physician
  • Carson, CA
  • NPI 1578647269
  Medicare reassignment NPD

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932254570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 CALLE DEL NORTE",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922705210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 CALLE DEL NORTE",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922705210",
            "telephone_number": "805-658-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROFFETT",
        "first_name": "GARY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A31780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A317800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Robert Presser, M.D.
• Leslie Miller Price, WHNP
• Private Solution Detox Corp. (SolutionPoint Behavioral Health)
• Private Solution Detox Corp.
• Private Solution Detox Corp. (Solution Point Behavioral Health)
• River Deann Pullins, SUDRC
• Pushpinder Sivia M.D., a Professional Corporation
• Quantum Healthcare Inc (Quantum Physical Therapy)
• Noah Arden Que, MD
• Kiana Star Quinonez

• General Practice Physician in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.