NPIMap

Individual provider Active NPI

Siraj Mohamed Gibani, M.D.

  • Neurological Surgery Physician
  • Pomona, CA
National Provider Identifier
1942521653
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
(909)331-2731 Issued in CA
Practice address
255 E Bonita Ave BLDG 9
Pomona, CA 91767-1923
Phone
(909) 450-0369
Fax
(909) 450-0366
NPI assigned
Jun 16, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X MT197841 PA
Neurological Surgery Physician 207T00000X (909)331-2731 CA Primary

Addresses

Primary practice location

255 E Bonita Ave BLDG 9
Pomona, CA 91767-1923

Mailing address

255 E Bonita Ave BLDG 9
Pomona, CA 91767-1923
Phone (909) 450-0369

Other practice location 1

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Other names 1

  • Dr. Sirajeddin Mohamed Gibani Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160511002535 CA Practitioner - Neurosurgery 9830488089 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Pennsylvania State University College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

255 E Bonita Ave
BLDG 9
Pomona, CA 91767-1923
Phone 9094500369213

Hospital & facility affiliations

  • Casa Colina Hospital Hospital, Pomona, CA, CCN 050782
  • Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231
  • Emanate Health Inter-Community Hospital Hospital, Covina, CA, CCN 050382
  • San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099
  • Emanate Health Foothill Presbyterian Hospital Hospital, Glendora, CA, CCN 050597

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion51
Laminectomy or laminotomy (partial removal of spine bones)33

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
(909)331-2731CAMDNeurological Surgery Physician
MT197841PAMDNeurological Surgery Physician

Practice roles (17 of 18)

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Mar 14, 2018 Accepting new patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara Neurological Surgery CurrentSince Mar 14, 2018 Accepting new patients
Yong Luke Lee Medical Corporation Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Sequoia Health Services Past Accepting new patients
Scott C Lederhaus MD & Lew B Disney MD PRT Lederhaus Scott C Gen PTR Past Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients
Usc Arcadia Hospital Past Accepting new patients
San Antonio Regional Hospital Past Accepting new patients
County of Santa Clara Past Accepting new patients
Dignity Health Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients

Locations

255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127

255 E Bonita Ave
Bldg 9
Pomona, CA 91767
Phone (909) 450-0369

255 E Bonita Ave
Ste 9
Pomona, CA 91767

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: casacolina@direct.casacolina.org

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1942521653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 E BONITA AVE BLDG 9",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671923",
            "telephone_number": "909-450-0369",
            "fax_number": "909-450-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 E BONITA AVE BLDG 9",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671923",
            "telephone_number": "909-450-0369",
            "fax_number": "909-450-0366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Pasteur Dr",
            "address_purpose": "LOCATION",
            "city": "Stanford",
            "state": "CA",
            "postal_code": "943052200",
            "country_code": "US",
            "telephone_number": "650-723-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBANI",
        "first_name": "SIRAJ",
        "middle_name": "MOHAMED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "PA",
            "license": "MT197841",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "(909)331-2731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SIRAJEDDIN",
            "last_name": "GIBANI",
            "middle_name": "MOHAMED",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.