Individual provider Active NPI

Bret Robert Gerber, M.D.

  • Pediatrics Physician
  • San Diego, CA
National Provider Identifier
1952328437
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G79213 Issued in CA
Practice address
11770 Bernardo Plaza CT Ste 250
San Diego, CA 92128-2425
Phone
(858) 251-3559
Fax
(858) 279-0377
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G79213 CA Primary

Addresses

Primary practice location

11770 Bernardo Plaza CT Ste 250
San Diego, CA 92128-2425

Mailing address

5150 Roxbury Rd
San Diego, CA 92116-2142
Phone (619) 204-3034

Other practice location 1

420 Heffernan Ave Ste D
Calexico, CA 92231-4718
Phone (760) 270-9126

Other identifiers 1

IdentifierTypeStateIssuer
GR0085-775MedicaidCA

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
I20170829002409 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 6204109168

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G79213CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piph, PC Pediatrics CurrentSince Oct 16, 2022 Accepting new patients
Calexico Wellness Center PastSince Mar 1, 2018 Accepting new patients

Locations

11770 Bernardo Plaza Ct
Ste 250
San Diego, CA 92128
Phone (858) 251-3559

Interoperability endpoints

  • Direct secure messaging: bret.gerber@3194.securemail.prognocis.com

Organizations & group practices 2

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1952328437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 ROXBURY RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921162142",
            "telephone_number": "619-204-3034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11770 BERNARDO PLAZA CT STE 250",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282425",
            "telephone_number": "858-251-3559",
            "fax_number": "858-279-0377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Heffernan Ave Ste D",
            "address_purpose": "LOCATION",
            "city": "Calexico",
            "state": "CA",
            "postal_code": "922314718",
            "country_code": "US",
            "telephone_number": "760-270-9126",
            "fax_number": "760-890-0005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GERBER",
        "first_name": "BRET",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-10-13",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G79213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0085-775",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.