Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MITALIBEN RAJENDRAKUMAR GOR NP, PMHNP
NPI 1114564630
Nurse Practitioner - Psychiatric/Mental Health in Poway, CA

Q: What is Mitaliben Gor's NPI number?

The NPI number for Mitaliben Gor is 1114564630. It was assigned to this individual provider in the NPPES registry on December 3, 2019.

Q: What is Mitaliben Gor's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Mitaliben Gor was last updated on September 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 58 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 03, 2019PECOS EnrolledAccepts Medicare Assignment

15611 POMERADO RD STE 535, POWAY, CA 92064(858) 279-1223 Get Directions Write a Review

NPPES record last updated: September 4, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 4, 2026, Aug 5, 2026, Dec 3, 2019 (3 updates tracked since 2019).

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About Mitaliben Rajendrakumar Gor Np, Pmhnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MITALIBEN RAJENDRAKUMAR GOR NP, PMHNP (NPI 1114564630) is an individual psychiatric/mental health provider in Poway, California, licensed in California (95038778) and active in the NPI registry since December 2019. She is enrolled in Medicare PECOS, is affiliated with Bay Area Hospital, and maintains a secondary practice location in Portland.

NPPES Registry Identity

NPI1114564630

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameMITALIBEN RAJENDRAKUMAR GORCredential: NP, PMHNP

Location Address15611 POMERADO RD STE 535Poway, CA 92064-2413

Mailing Address15611 Pomerado Rd Ste 535Poway, CA 92064-2413 · (858) 279-1223 · Fax (858) 467-7161

Phone(858) 279-1223

Sole ProprietorYes

Medical School CMSGeorge Washington University School Of MedicineGraduated 2021

Enumeration DateDecember 3, 2019

Last NPPES UpdateSeptember 4, 20263 updates tracked since enumeration

NPPES CertifiedSeptember 4, 2026

✔ NPI 1114564630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

Licenses✔ Licensed in CA · 95038778✔ Licensed in OR · 201909528NP-PP

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 95038778 (CA), 201909528NP-PP (OR)

15611 POMERADO RD STE 535, Poway, CA 92064

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Secondary Practice Location 1

Location 110260 SW Greenburg Rd Fl 4Portland, OR 97223-5500 · Phone (646) 941-7645

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mitaliben Rajendrakumar Gor Np, Pmhnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1254766330

PECOS Enrollment IDI20200117001671, I20260819000827

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Mitaliben Gor reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pacific Coast Psychiatric Associates Inc

299 mi

Clinical

7373 N SCOTTSDALE RD STE A199
Scottsdale, AZ 85253

Reassigned Medicare billing, California enrollment
766 clinicians in this Medicare group

NPI 1023125465 (702) 805-5360

North Bend Medical Center Inc

815 mi

Diagnostic Radiology

1900 WOODLAND DR
Coos Bay, OR 97420

Reassigned Medicare billing, Oregon enrollment
220 clinicians in this Medicare group

NPI 1063428308 (541) 267-5151

Omar Osman MD PC

1,713 mi

Physical Medicine & Rehabilitation

9400 MARION AVE
Morton Grove, IL 60053

Reassigned Medicare billing, California enrollment
Medicare enrollment name: Omar Osman Practice, LLC
53 clinicians in this Medicare group

NPI 1669192472 (855) 611-8783

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

135 services99 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

87 services76 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

65 services65 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

60 services60 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

39 services36 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

27 services25 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Bay Area Hospital

Acute Care Hospitals · Coos Bay, OR

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number380090

Location1775 Thompson RoadCoos Bay, OR 97420 · Coos County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92064 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.87 typical visit price

range $62.10 – $184.71

Typical copayment $23.71 (range $15.52 – $46.17)

Most-billed visit code 99203

Established Patient

$108.42 typical visit price

range $20.62 – $151.42

Typical copayment $27.10 (range $5.15 – $37.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSICA WALLACE

Marriage & Family Therapist