NPIMap

Individual provider Active NPI

Chetan Gondha, MD

  • Internal Medicine Physician
  • Ventura, CA
National Provider Identifier
1992715155
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A113015 Issued in CA
Practice address
168 N. Brent Street
Suite 404
Ventura, CA 93003
Phone
(805) 641-6525
Fax
(805) 641-6530
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 057628 GA
Internal Medicine Physician 207R00000X A113015 CA Primary

Addresses

Primary practice location

168 N. Brent Street
Suite 404
Ventura, CA 93003

Mailing address

168 N. Brent Street
Suite 404
Ventura, CA 93003
Phone (805) 641-6525

Other practice location 1

300 Hillmont Ave
Ventura, CA 93003-1651
Phone (805) 652-6674

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address chetan.gondha@ventura.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101111000618 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 0749289114 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Covington Menz Lyche and Lin Medical GPGroup PAC ID 2860449865, 9 clinicians
County of VenturaGroup PAC ID 7911810171, 340 clinicians

Practice addresses (Care Compare)

168 N Brent St
Suite 404
Ventura, CA 93003-2824
Phone (805) 641-6525

300 Hillmont Ave
Ventura, CA 93003-1651
Phone (805) 654-3306

Hospital & facility affiliations

  • Community Memorial Hospital - Ventura Hospital, Ventura, CA, CCN 050394

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy165
Upper gastrointestinal (GI) endoscopy for acid reflux166

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A113015CAMDInternal Medicine Physician
057628GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Memorial Health System CurrentSince May 1, 2014 Accepting new patients
Island View Gastroenterology Assoc. CurrentSince Oct 19, 2010 Accepting new patients
Community Memorial Health System CurrentSince May 1, 2014 Accepting new patients
Ventura Endoscopy Center LLC PastSince Jul 1, 2012 Accepting new patients

Locations

168 N Brent St
Ste 404
Ventura, CA 93003
Phone (805) 641-6525

5855 Olivas Park Dr
Ventura, CA 93003
Phone (805) 652-5469

147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011

Interoperability endpoints

  • Direct secure messaging: chetan.gondha@ventura.cernerdirect.com
  • Direct secure messaging: chetangondha@ivga.allscriptsdirect.net

Organizations & group practices 5

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 10

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1992715155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 N. BRENT STREET",
            "address_2": "SUITE 404",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "93003",
            "telephone_number": "805-641-6525",
            "fax_number": "805-641-6530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 N. BRENT STREET",
            "address_2": "SUITE 404",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "93003",
            "telephone_number": "805-641-6525",
            "fax_number": "805-641-6530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Hillmont Ave",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930031651",
            "country_code": "US",
            "telephone_number": "805-652-6674",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONDHA",
        "first_name": "CHETAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "057628",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A113015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chetan.gondha@ventura.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Cerner Direct Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Information",
            "address_1": "300 Hillmont Ave",
            "city": "Ventura",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930031651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.