Gina Evelyn Vescovo, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A055462 Issued in CA

Practice address

1057 Pine Ave
Long Beach, CA 90813-3118

Phone

(562) 264-3558

Fax

(562) 366-5903

NPI assigned

May 28, 2007

Sex

Female

Sole proprietor

No

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: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: gvescovomd18785@direct.memorialcare.org

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.

• Providence Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1235182569
  NPD (past)
• Providence Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1417915760
  NPD (past)

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

{
    "created_epoch": "1180310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1942411178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17035 FAYSMITH AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905042411",
            "telephone_number": "310-721-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 PINE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133118",
            "telephone_number": "562-264-3558",
            "fax_number": "562-366-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VESCOVO",
        "first_name": "GINA",
        "middle_name": "EVELYN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-28",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A055462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISCENSURE",
            "identifier": "A055462",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terri Lynn Verone, R.D.
• Verosyl Health Services
• Verosyl Professional Nursing Corporation
• Dejuan L Verrett
• Robert Jack Verwys, LCSW
• Veterans Afairs
• Veterans Affairs
• Veterans Affairs Medical Center
• Nicole B Viado, P.T.
• Ana Aleida Viana

• Family Medicine Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; 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.