Individual provider Active NPI

Oliver Holger Gantz, M.D.

  • Otolaryngology Physician
  • Thousand Oaks, CA
National Provider Identifier
1952758260
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
147332 Issued in CA
Practice address
100 Moody CT Ste 200
Thousand Oaks, CA 91360-6082
Phone
(805) 418-3500
NPI assigned
May 17, 2016
Last updated
Sep 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Otolaryngology Physician 207Y00000X 147332 CA Primary

Addresses

Primary practice location

100 Moody CT Ste 200
Thousand Oaks, CA 91360-6082

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

1540 Alcazar Street
Suite 204
Los Angeles, CA 90033
Phone (323) 442-4830

Other practice location 2

27235 Tourney Rd Ste 2500
Santa Clarita, CA 91355-5908
Phone (661) 253-5851

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
I20200803001002 CA Practitioner - Otolaryngology 3779854369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Regents of the University of CaliforniaGroup PAC ID 6406749308, 33 clinicians

Practice addresses (Care Compare)

100 Moody CT
Thousand Oaks, CA 91360-6077
Phone (805) 418-3500

200 Medical Plaza
Suite 550
Los Angeles, CA 90024-7002
Phone (310) 794-1110

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.82 of 100Reported as group
Quality
86.3
Promoting interoperability
100
Improvement activities
40
Cost
76.99

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
147332CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California CurrentSince Sep 1, 2020 Accepting new patients
UCLA Medical Group Past Accepting new patients
The Regents of the University of California Past Accepting new patients

Locations

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 54206
Los Angeles, CA 90074

100 Moody Ct
Ste 100
Thousand Oaks, CA 91360
Phone (805) 418-3444

100 Moody Ct
Ste 200
Thousand Oaks, CA 91360
Phone (805) 418-3500

27235 Tourney Rd
Ste 2500
Valencia, CA 91355
Phone (661) 253-5851

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1952758260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MOODY CT STE 200",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913606082",
            "telephone_number": "805-418-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1540 Alcazar Street",
            "address_2": "Suite 204",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90033",
            "country_code": "US",
            "telephone_number": "323-442-4830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "27235 Tourney Rd Ste 2500",
            "address_purpose": "LOCATION",
            "city": "Santa Clarita",
            "state": "CA",
            "postal_code": "913555908",
            "country_code": "US",
            "telephone_number": "661-253-5851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANTZ",
        "first_name": "OLIVER",
        "middle_name": "HOLGER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-17",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "147332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.