Individual provider Active NPI

Gabriele Engelhardt, M.D.

  • Internal Medicine Physician
  • Redondo Beach, CA
National Provider Identifier
1992810634
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A75461 Issued in CA
Practice address
520 N Prospect Ave Ste 103
Redondo Beach, CA 90277-3033
Phone
(310) 376-8816
Fax
(310) 374-2806
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A75461 CA Primary

Addresses

Primary practice location

520 N Prospect Ave Ste 103
Redondo Beach, CA 90277-3033

Mailing address

520 N Prospect Ave Ste 103
Redondo Beach, CA 90277-3033
Phone (310) 376-8816

Other identifiers 1

IdentifierTypeStateIssuer
W475461AMedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gengelhardt199033@oc.providencedirect.org

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
I20050225000527 CA Practitioner - Internal Medicine 6507819943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

4101 Torrance Blvd
Torrance, CA 90503-4607
Phone (310) 303-7496

Hospital & facility affiliations

  • Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A75461CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute Internal Medicine CurrentSince Dec 1, 2004 Accepting new patients
Providence Medical Institute Internal Medicine CurrentSince Dec 1, 2004 Accepting new patients
Providence Health System Southern California Past Accepting new patients
University Health System, Inc. Past Accepting new patients

Locations

21501 Avalon Blvd
Ste 100
Carson, CA 90745
Phone (310) 835-6627

520 N Prospect Ave
Ste 103
Redondo Beach, CA 90277
Phone (310) 374-9646

1294 W 6th St
Ste 103
San Pedro, CA 90731
Phone (310) 831-9482

4101 Torrance Blvd
Torrance, CA 90503
Phone (310) 540-7676

4201 Torrance Blvd
Ste 260
Torrance, CA 90503
Phone (424) 212-5333

21311 Madrona Ave
Ste 101
Torrance, CA 90503
Phone (310) 792-4012

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 1

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1992810634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N PROSPECT AVE STE 103",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773033",
            "telephone_number": "310-376-8816",
            "fax_number": "310-374-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N PROSPECT AVE STE 103",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773033",
            "telephone_number": "310-376-8816",
            "fax_number": "310-374-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELHARDT",
        "first_name": "GABRIELE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A75461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "W475461A",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gengelhardt199033@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4101 Torrance Blvd",
            "city": "Torrance",
            "state": "CA",
            "country_code": "US",
            "postal_code": "905034607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

Verify at the official NPI Registry.