MARY ELIZABETH GAMBOA
NPI 1124605530
Pediatrics in Mission Viejo, CA

Q: What is Mary Gamboa's NPI number?

The NPI number for Mary Gamboa is 1124605530. It was assigned to this individual provider in the NPPES registry on March 24, 2021.

Q: What is Mary Gamboa's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Mary Gamboa was last updated on May 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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 March 24, 2021PECOS Enrolled

23781 MAQUINA, MISSION VIEJO, CA 92691(833) 574-2273 Get Directions Write a Review

NPPES record last updated: May 27, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 27, 2025, Mar 18, 2025, Jun 21, 2021 and 1 more (4 updates tracked since 2021).

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About Mary Elizabeth Gamboa NPPES

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

MARY ELIZABETH GAMBOA (NPI 1124605530) is an individual pediatrics provider in Mission Viejo, California, licensed in California (A196140) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124605530

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameMARY ELIZABETH GAMBOA

Location Address23781 MAQUINAMission Viejo, CA 92691-2716

Mailing Address23781 MaquinaMission Viejo, CA 92691-2716

Phone(833) 574-2273

Sole ProprietorNo

Enumeration DateMarch 24, 2021

Last NPPES UpdateMay 27, 20254 updates tracked since enumeration

NPPES CertifiedMarch 18, 2025

✔ NPI 1124605530 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Licenses✔ Licensed in CA · A196140✔ Licensed in WA · ML61164947

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

23781 MAQUINA, Mission Viejo, CA 92691

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Elizabeth Gamboa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92691 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

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

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 19

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

DR. AMY TRAN BUENROSTRO PHARM.D.

Pharmacist