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GAMAL M. GHONIEM M.D.
NPI 1467415919
Urology in Orange, CA

Active since April 07, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
101 THE CITY DR S, ORANGE, CA 92868(714) 456-5378(714) 456-5062 Get Directions Write a Review

NPPES record last updated: August 18, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Gamal M. Ghoniem M.d. NPPES

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

GAMAL M. GHONIEM M.D. (NPI 1467415919) is an individual urology provider in Orange, California, licensed in California (C54137) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1974).

NPPES Registry Identity

NPI1467415919
Entity TypeIndividualMale
Primary Taxonomy208800000X
Provider Legal NameGAMAL M. GHONIEMCredential: M.D.
Location Address101 THE CITY DR SOrange, CA 92868-3201
Mailing Address101 The City Dr SOrange, CA 92868-3201 · (714) 456-5378 · Fax (714) 456-5062
Phone(714) 456-5378
Fax(714) 456-5062
Sole ProprietorNo
Medical School CMSOtherGraduated 1974
Enumeration DateApril 7, 2006
Last NPPES UpdateAugust 18, 2011
✔ NPI 1467415919 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Licenses✔ Licensed in CA · C54137✔ Licensed in FL · ME0080267
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
101 THE CITY DR S, Orange, CA 92868
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Other Identifiers 4

Medicaid00C541370CA
Medicare UPINB64556FL
Medicare PINFD193ZCA
Medicaid258724600FL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gamal M. Ghoniem M.d. 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 ID4183754302
PECOS Enrollment IDI20110719000015
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.

Areas of Expertise CMS Part B claims 19

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.
66 services54 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.
54 services40 patients
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.
30 services26 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.
29 services27 patients
Electronic assessment of bladder emptying 51741
Electronic assessment of bladder emptying is a non-invasive test that measures how well your bladder functions. It uses ultrasound technology to create images of your bladder before and after you use the restroom, helping to identify any issues with bladder emptying.
18 services18 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.
18 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92868 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
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality82.4
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 9

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Lubricant, individual sterile packet, each A4332
DME-Medical/Surgical Supplies · category DA000N
3 suppliers27 claims4,520 services$0.11 avg. paid by Medicare
Male external catheter, with or without adhesive, disposable, each A4349
DME-Medical/Surgical Supplies · category DA000N
3 suppliers32 claims1,089 services$1.81 avg. paid by Medicare
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351
DME-Orthotic Devices · category DF008N
7 suppliers117 claims26,350 services$1.47 avg. paid by Medicare
Intermittent urinary catheter, with insertion supplies A4353
DME-Orthotic Devices · category DF008N
4 suppliers33 claims5,450 services$6.79 avg. paid by Medicare
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357
DME-Orthotic Devices · category DF000N
3 suppliers19 claims41 services$8.94 avg. paid by Medicare
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each A4358
DME-Orthotic Devices · category DF000N
2 suppliers15 claims36 services$5.31 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

DR. ANKIT BHUPENDRA PATEL D.O.
Radiology (Diagnostic Radiology)
101 THE CITY DR S
ORANGE, CA 92868
Orange County (714) 456-5113
DR. LAURA CATHERINE SKOCZYLAS MD
Obstetrics & Gynecology
101 THE CITY DR S, BUILDING 56, DEPARTMENT OF OB/GYN
ORANGE, CA 92868
Orange County (714) 456-8224
MICHAEL CHENG DO
Internal Medicine (Rheumatology)
101 THE CITY DR S
ORANGE, CA 92868
Orange County (714) 456-7110
AESTHETIC AND PLASTIC SURGERY INSTITUTE
Plastic Surgery
101 THE CITY DR S
ORANGE, CA 92868
Orange County (714) 456-2986
JOSEPH VILLARREAL M.D.
Emergency Medicine
101 THE CITY DR S, BUILDING 1A, ROOM 1009
ORANGE, CA 92868
Orange County (714) 456-5239
DEMI TRAN
Psychiatry & Neurology (Neurology)
101 THE CITY DR S, CITY TOWER, SUITE 400
ORANGE, CA 92868
Orange County (171) 456-6693
DR. ISABEL CARLTON CLARK M.D.
Surgery (Trauma Surgery)
101 THE CITY DR S
ORANGE, CA 92868
Orange County (714) 456-7890
DYLAN LUKATO
Emergency Medicine
101 THE CITY DR S
ORANGE, CA 92868
Orange County (415) 218-8041

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gamal M. Ghoniem's NPI number?

The NPI number for Gamal M. Ghoniem is 1467415919. It was assigned to this individual provider in the NPPES registry on April 7, 2006.

Where is Gamal M. Ghoniem located?

Gamal M. Ghoniem practices at 101 The City Dr S, Orange, CA 92868. The listed phone number is (714) 456-5378.

What is Gamal M. Ghoniem's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Gamal M. Ghoniem enrolled in Medicare?

Yes. Gamal M. Ghoniem is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Gamal M. Ghoniem was last updated on August 18, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.