Individual provider Active NPI

Dmitriy Gen, D.O.

  • Family Medicine Physician
  • Glendale, CA
National Provider Identifier
1962701227
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A11253 Issued in CA
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

Updated by the provider on Jun 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110912000626 CA Practitioner - Family Practice 6800067448 Reassigns benefits to 1 organization

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
Adventist Health Physicians NetworkGroup PAC ID 3274580972, 628 clinicians

Practice addresses (Care Compare)

2750 Sycamore Dr
Simi Valley, CA 93065-1500

Hospital & facility affiliations

  • Brand Home Health Care Inc Home health agency, Glendale, CA, CCN 559447
  • Glendale Adventist Medical Center Hospital, Glendale, CA, CCN 050239

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
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

LicenseStateTypeSpecialty
20A11253CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network Family Medicine Current Accepting new patients
Adventist Health Physicians Network CurrentSince Jul 1, 2012 Accepting new patients
Adventist Health Physicians Network CurrentSince Jul 1, 2012 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.

Hospital & facility affiliations 2

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": "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

Verify at the official NPI Registry.