MR. DARCESEAN GAMBLE PA NPI 1003012162

Physician Assistant in Sherman Oaks, CA

NPI 1003012162 Individual Male Years of Experience 24 Physician Assistant PECOS Enrolled Accepts Medicare Approved Payment

NPI Profile for MR. DARCESEAN GAMBLE PA

Darcesean Gamble is a primary care provider established in Sherman Oaks, California and his medical specialization is physician assistant with more than 24 years of experience. The NPI number of Darcesean Gamble is 1003012162 and was assigned on June 2007. The practitioner's primary taxonomy code is 363A00000X with license number PA 15713 (CA). The provider is registered as an individual and his NPI record was last updated 15 years ago.

A primary care provider (PCP) like Mr. Darcesean Gamble Pa sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Darcesean Gamble is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Darcesean Gamble is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Southern California Hospital At Hollywood.

The typical physician office visit costs for Medicare beneficiaries in this area are: $24.87 for a new patient copayment and $20.28 for an established patient copayment.

NPI

1003012162

Provider NameMR. DARCESEAN GAMBLE PA
Provider Location Address4955 VAN NUYS BLVD STE 411 SHERMAN OAKS, CA 91403
Provider Mailing Address5137 ONAKNOLL AVE LOS ANGELES, CA 90043
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1999
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date06-25-2007
Last Update Date07-08-2007


Primary Taxonomy

Taxonomy Code363A00000X
ClassificationPhysician Assistant
TypePhysician Assistants & Advanced Practice Nursing Providers
License No.PA 15713
License StateCA
Taxonomy DescriptionA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Business Address

MR. DARCESEAN GAMBLE PA
4955 VAN NUYS BLVD STE 411
SHERMAN OAKS, CA
ZIP 91403
Phone: (818) 784-1195

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Mailing Address

MR. DARCESEAN GAMBLE PA
5137 ONAKNOLL AVE
LOS ANGELES, CA
ZIP 90043
Phone: (310) 403-2510



PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID2365471562
PECOS Enrollment IDI20050808001180
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 91403 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99203
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$65.18 $194.87 $99.5
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$16.29 $48.71 $24.87
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99213
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$20.89 $159.82 $81.14
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$5.22 $39.95 $20.28

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Darcesean Gamble is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD6245 DE LONGPRE AVE
HOLLYWOOD, CA 90028
(323) 462-2271Acute Care Hospitals50135

NPI Validation Check Digit Calculation


The following table explains step by step the NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1003012162
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003014112
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 1 + 4 + 1 + 1 + 2 + 24 = 38
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
40 - 38 = 22

The NPI number 1003012162 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1659947380MRS. AGNES E GONZAGA FNP
Individual
Nurse Practitioner (Family)4955 VAN NUYS BLVD STE 411
SHERMAN OAKS, CA 91403
(818) 784-1195

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Mr. Darcesean Gamble Pa is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.