Active NPI
Dmitriy Gen, D.O.
- Family Medicine Physician
- Glendale, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20A11253
- Practice address
- 1560 E Chevy Chase Dr
Glendale, CA 91206-4197 - Phone
- (818) 246-5900
- NPI assigned
- Mar 24, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20A11253 | CA | Primary |
Addresses
Primary practice location
1560 E Chevy Chase Dr
Glendale, CA 91206-4197
Mailing address
1560 E Chevy Chase Dr
Glendale, CA 91206-4197
Phone (818) 246-5900
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2750 Sycamore Dr
Simi Valley, CA 93065-1500
Hospital & facility affiliations
- Brand Home Health Care Inc
- Glendale Adventist Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.77 of 100
- Quality
- 81.54
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A11253 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adventist Health Physicians Network | Family Medicine | Current | Accepting new patients |
| Adventist Health Physicians Network | Current | Accepting new patients | |
| Adventist Health Physicians Network | Current | Accepting new patients |
Locations
1560 E Chevy Chase Dr
Ste 245
Glendale, CA 91206
Phone (818) 246-5900
1975 Verdugo Blvd
Ste A
La Canada Flintridge, CA 91011
Phone (747) 212-3441
301 Science Dr
Ste 150
Moorpark, CA 93021
Phone (805) 855-7000
124 Macaw Ln
Simi Valley, CA 93065
Phone (805) 306-0304
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Glendale, CA
- NPI 1083976294
-
- Physical Therapy Clinic/Center
- Paradise, CA
- NPI 1134092190
-
- Urgent Care Clinic/Center
- Moorpark, CA
- NPI 1992244503
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Glendale, CA
- NPI 1073161162
-
- General Acute Care Hospital
- Glendale, CA
- NPI 1831188275
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309392000000",
"number": "1962701227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1560 E CHEVY CHASE DR",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912064197",
"telephone_number": "818-246-5900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1560 E CHEVY CHASE DR",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912064197",
"telephone_number": "818-246-5900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEN",
"first_name": "DMITRIY",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-03-24",
"last_updated": "2011-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "20A11253",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.