Individual provider Active NPI

Geoff Lange, D.O.

  • Family Medicine Physician
  • La Quinta, CA
National Provider Identifier
1952764052
Registry record updated Aug 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A15796 Issued in CA
Practice address
45280 Seeley Dr FL 2
La Quinta, CA 92253-6834
Phone
(760) 610-7300
Fax
(760) 610-7301
NPI assigned
Apr 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 20A15796 CA
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 20A15796 CA Primary

Addresses

Primary practice location

45280 Seeley Dr FL 2
La Quinta, CA 92253-6834

Mailing address

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Phone (760) 610-7300

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
I20191010001742 CA Practitioner - Family Practice 5294009064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SD Sports Medicine and Family Health CenterGroup PAC ID 7113812496, 38 clinicians

Practice addresses (Care Compare)

6699 Alvarado Rd
Suite 2100
San Diego, CA 92120-5238
Phone (619) 229-3909

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.4 of 100Reported as group
Quality
93.75
Promoting interoperability
100
Improvement activities
40
Cost
74.23

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions12
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15796CAMDAcupuncturist
20A15796CAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SD Sports Medicine and Family Health Center CurrentSince Sep 1, 2020 Accepting new patients
Regents of the University of California Family Medicine Past Accepting new patients
Regents of the University of California Past Accepting new patients
Eisenhower Medical Center Past Accepting new patients

Locations

6699 Alvarado Rd
Ste 2100
San Diego, CA 92120
Phone (619) 229-3909

Organizations & group practices 4

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.

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": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1952764052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-610-7300",
            "fax_number": "760-610-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45280 SEELEY DR FL 2",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922536834",
            "telephone_number": "760-610-7300",
            "fax_number": "760-610-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "GEOFF",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-05",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "20A15796",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A15796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Quinta, CA

Sources for this page

Verify at the official NPI Registry.