Individual provider Active NPI

Gary L Cushing, M.D.

  • Gastroenterology Physician
  • San Luis Obispo, CA
National Provider Identifier
1962483545
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A45253 Issued in CA
Practice address
1551 Bishop St
Suite 510
San Luis Obispo, CA 93401
Phone
(805) 549-7843
Fax
(805) 549-8692
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A45253 CA Primary
Specialist 174400000X A45253 CA

Addresses

Primary practice location

1551 Bishop St
Suite 510
San Luis Obispo, CA 93401

Mailing address

4488 Cross Creek Way
San Luis Obispo, CA 93401-8388
Phone (805) 801-5355

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
I20100514000774 CA Practitioner - Gastroenterology 1153396007 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A45253CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
First Choice Physician Partners Current Accepting new patients
Central Coast Gastroenterology Medical Group Gastroenterology Current Accepting new patients
First Choice Physician Partners CurrentSince Aug 27, 2021 Accepting new patients
First Choice Physician Partners CurrentSince Aug 27, 2021 Accepting new patients
First Choice Physician Partners Past Accepting new patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients

Locations

35 Casa St
Ste 130
San Luis Obispo, CA 93405
Phone (805) 541-1422

1010 Murray Ave
Sn Luis Obisp, CA 93405
Phone (805) 546-7600

1551 Bishop St
Ste 510
Sn Luis Obisp, CA 93401
Phone (805) 434-5530

1100 Las Tablas Rd
Templeton, CA 93465
Phone (805) 434-3500

Organizations & group practices 6

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": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1962483545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4488 CROSS CREEK WAY",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934018388",
            "telephone_number": "805-801-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 BISHOP ST",
            "address_2": "SUITE 510",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93401",
            "telephone_number": "805-549-7843",
            "fax_number": "805-549-8692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSHING",
        "first_name": "GARY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A45253",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A45253",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.