Individual provider Active NPI

Aaron Michael Gilmore, D.O., M.S.

  • Psychiatry Physician
  • Loma Linda, CA
National Provider Identifier
1942655527
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20A16352 Issued in CA
Practice address
11234 Anderson St
Loma Linda University Health - Psychiatry Residency
Loma Linda, CA 92354-2804
Phone
(909) 558-9532
NPI assigned
May 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 20A16352 CA Primary

Addresses

Primary practice location

11234 Anderson St
Loma Linda University Health - Psychiatry Residency
Loma Linda, CA 92354-2804

Mailing address

1686 Barton Rd
Redlands, CA 92373-1488
Phone (909) 558-9500

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20210628003319 CA Practitioner - Psychiatry 4284035262 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Master of Science

State licenses

LicenseStateTypeSpecialty
20A16352CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jan 30, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 30, 2023 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Aug 1, 2021 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Psychiatry CurrentSince Aug 1, 2021 Accepting new patients

Locations

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11234 Anderson St
Ofc
Loma Linda, CA 92350
Phone (909) 558-4074

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

1686 Barton Rd
Redlands, CA 92373
Phone (909) 558-9200

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

Interoperability endpoints

  • Direct secure messaging: agilmore94790@direct.llu.edu

Organizations & group practices 5

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": "1462147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1942655527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1686 BARTON RD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923731488",
            "telephone_number": "909-558-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "LOMA LINDA UNIVERSITY HEALTH - PSYCHIATRY RESIDENCY",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-9532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "AARON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-02",
        "last_updated": "2023-03-27",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A16352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.