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DR. JACK M. GINDI M.D.
NPI 1518048255
Internal Medicine in Agoura Hills, CA

Active since October 18, 2006Opted out of Medicare · through Oct 1, 2027CLIA 05D0970132 · Waiver
29525 CANWOOD ST, SUITE # 209, AGOURA HILLS, CA 91301(818) 706-7773(818) 706-0390 Get Directions Write a Review

NPPES record last updated: January 6, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jack M. Gindi M.d. NPPES

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

DR. JACK M. GINDI M.D. (NPI 1518048255) is an individual internal medicine provider in Agoura Hills, California, licensed in California (G056963) and active in the NPI registry since October 2006. He has opted out of Medicare through October 1, 2027 and remains eligible to order and refer and holds a CLIA Waiver certificate valid through February 3, 2028.

NPPES Registry Identity

NPI1518048255
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. JACK M. GINDICredential: M.D.
Location Address29525 CANWOOD ST, SUITE # 209Agoura Hills, CA 91301-4233
Mailing Address29525 Canwood St, Suite # 209Agoura Hills, CA 91301-4233 · (818) 706-7773 · Fax (818) 706-0390
Phone(818) 706-7773
Fax(818) 706-0390
Sole ProprietorYes
Enumeration DateOctober 18, 2006
Last NPPES UpdateJanuary 6, 2022
NPPES CertifiedJanuary 6, 2022
✔ NPI 1518048255 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · G056963
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
29525 CANWOOD ST, Agoura Hills, CA 91301
Open in Google Maps ↗

Other Identifiers 2

OtherG056963CA · Medical License
Other37-1440121Tax Id #

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jack M. Gindi M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2013 through October 1, 2027.

Opt-Out Effective DateOctober 1, 2013
Opt-Out In Effect ThroughOctober 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0970132

Jack M Gindi MD · Agoura Hills, CA
Active · expires Feb 3, 2028
CLIA Number05D0970132
Laboratory TypePhysician Office
Certificate Effective DateFebruary 4, 2026
Certificate Expiration DateFebruary 3, 2028
Laboratory DirectorJack M. Gindi MD
Laboratory Phone(818) 706-7773
Laboratory LocationJack M Gindi MD29525 Canwood St Ste 209, Agoura Hills, CA 91301
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91301 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
$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 20

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

DR. PENNY JEAN CHONG M.D.
Internal Medicine (Rheumatology)
29525 CANWOOD ST, SUITE 205
AGOURA HILLS, CA 91301
Los Angeles County (818) 781-5195
ANITA P SINGH-CRAIGHEAD M.D.
Obstetrics & Gynecology (Reproductive Endocrinology)
29525 CANWOOD ST, STE 210
AGOURA HILLS, CA 91301
Los Angeles County (818) 889-4532
JEROLD T. LITOFF, A PROFESSIONAL CORP.
Neuromusculoskeletal Medicine, Sports Medicine
29525 CANWOOD ST, SUITE 107
AGOURA HILLS, CA 91301
Los Angeles County (818) 706-1235
MS. TARA MARIE SCHROETER MFT
Marriage & Family Therapist
29525 CANWOOD ST, STE#309
AGOURA HILLS, CA 91301
Los Angeles County (818) 624-4261
AFFILIATES IN MEDICAL SPECIALTIES MEDICAL GROUP INC
Internal Medicine
29525 CANWOOD ST, SUITE 300
AGOURA HILLS, CA 91301
Los Angeles County (818) 706-2477
COLLETTE LEE KING FNP
Nurse Practitioner (Family)
29525 CANWOOD ST, SUITE 300
AGOURA HILLS, CA 91301
Los Angeles County (818) 706-2477
BENTE H BERMAN M.D.
Dermatology
29525 CANWOOD ST, SUITE 219
AGOURA HILLS, CA 91301
Los Angeles County (818) 865-8133
ROBERT STEPHEN DYE M.D.
Dermatology (Procedural Dermatology)
29525 CANWOOD ST, SUITE #219
AGOURA HILLS, CA 91301
Los Angeles County (818) 865-8133

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 Jack Gindi's NPI number?

The NPI number for Jack Gindi is 1518048255. It was assigned to this individual provider in the NPPES registry on October 18, 2006.

Where is Jack Gindi located?

Jack Gindi practices at 29525 Canwood St Suite # 209, Agoura Hills, CA 91301. The listed phone number is (818) 706-7773.

What is Jack Gindi's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jack Gindi enrolled in Medicare?

No. Jack Gindi has opted out of Medicare through October 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Does Jack Gindi hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0970132) is associated with this NPI, valid through February 3, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jack Gindi was last updated on January 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.