DR. BRIAN RANDALL GANTWERKER M.D.
NPI 1609842715
Neurological Surgery in Santa Monica, CA
NPI Status: Active since February 28, 2006
Contact Information
2811 WILSHIRE BLVD
SUITE 840
SANTA MONICA, CA
ZIP 90403
Phone: (310) 694-8300
Fax: (310) 694-8357
- Individual
- Male
- Neurological Surgery
- PECOS Enrolled
- Opted-Out Medicare
- Medicare Quality Reporting
About BRIAN GANTWERKER
This page provides the complete NPI Profile along with additional information for Brian Gantwerker, a provider established in Santa Monica, California with a medical specialization in Neurological Surgery. The healthcare provider is registered in the NPI registry with number 1609842715 assigned on February 2006. The practitioner's primary taxonomy code is 207T00000X with license number A109316 (CA). The provider is registered as an individual and his NPI record was last updated 10 years ago.
- NPI
- 1609842715
- Provider Name
- DR. BRIAN RANDALL GANTWERKER M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2811 WILSHIRE BLVD SUITE 840 SANTA MONICA, CA 90403
- Location Phone
- (310) 694-8300
- Location Fax
- (310) 694-8357
- Mailing Address
- PO BOX 492209 LOS ANGELES, CA 90049
- Mailing Phone
- (310) 694-8300
- Mailing Fax
- (310) 694-8357
- Is Sole Proprietor?
- No
- Enumeration Date
- 02-28-2006
- Last Update Date
- 06-14-2016
- Code Navigator
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Brian Gantwerker opted out of Medicare effective on 01-02-2023 until 01-02-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Neurological Surgery
- Taxonomy Code
- 207T00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- A109316
- License State
- CA
- Taxonomy Description
- A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.
Medicare Participation & PECOS Enrollment Status
Brian Gantwerker 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.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 01-02-2023
Opt-Out End Date: 01-02-2027
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Computer-assisted spinal procedure
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Fusion of additional segment of spine
Fusion of lower spine bone through abdomen with partial removal of disc
Fusion of spine in lower back
Initial hospital inpatient care per day, typically 70 minutes
Insertion of cage or mesh device to spine bone and disc space during spine fusion
New patient office or other outpatient visit, 45-59 minutes
Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment
Partial removal of spine bone with release of spinal cord and/or nerves, each additional segment
Placement of stabilizing device to back, 3-6 spine bone segments
Reprogramming of cerebrospinal fluid shunt
A computer-assisted spinal procedure is a surgical technique that uses computer technology for improved precision. It involves creating a 3D image of your spine to guide the surgeon during the operation. This method enhances accuracy, reduces risk, and promotes quicker recovery.
This service was performed 15 times for 15 patientsThis 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.
This service was performed 407 times for 219 patientsThis 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.
This service was performed 405 times for 238 patientsFusion of an additional segment of the spine is a surgical procedure to join two or more vertebrae together. This is done to stabilize the spine and reduce pain or correct a deformity. The procedure involves using bone grafts, rods, or screws to secure the spine.
This service was performed 28 times for 16 patientsThis procedure involves merging the bones in your lower spine through an abdominal approach. A portion of the disc, which acts like a cushion between your vertebrae, is partially removed. The goal is to alleviate back pain by limiting movement in the problem area of your spine.
This service was performed 20 times for 19 patientsFusion of the spine in the lower back, also known as lumbar spinal fusion, is a surgery aimed to join, or fuse, two or more vertebrae in your lower back. This procedure can help alleviate pain and improve stability by reducing movement between the vertebrae.
This service was performed 20 times for 20 patientsInitial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
This service was performed 12 times for 12 patientsSpine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.
This service was performed 33 times for 23 patientsThis is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
This service was performed 141 times for 141 patientsThis procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.
This service was performed 43 times for 42 patientsThis procedure involves the partial removal of a bone in your spine to alleviate pressure on your spinal cord or nerves. It may be performed on multiple spine segments depending on your condition. The aim is to improve mobility and reduce pain or discomfort.
This service was performed 55 times for 33 patientsThis procedure involves placing a device on your back to stabilize 3-6 spine bone segments. It aids in maintaining spine alignment and reducing pain. The device is secured to the bones, providing support and promoting healing.
This service was performed 20 times for 20 patientsReprogramming of a cerebrospinal fluid shunt is a process to adjust the device that helps regulate the flow of fluid around your brain. This adjustment ensures the shunt is working correctly, reducing symptoms and improving your comfort.
This service was performed 21 times for 11 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 90403 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $142.39
- Minimum New Patient Price $62.96
- Maximum New Patient Price $187.6
- Average New Patient Copayment $35.59
- Minimum New Patient Copayment $15.74
- Maximum New Patient Copayment $46.9
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $77.96
- Minimum Established Patient Price $20.84
- Maximum Established Patient Price $153.61
- Average Established Patient Copayment $19.49
- Minimum Established Patient Copayment $5.21
- Maximum Established Patient Copayment $38.4
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Engagement of patients through implementation of improvements in patient portal | Yes | N/A |
| Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence. | ||
| Implementation of improvements that contribute to more timely communication of test results | Yes | N/A |
| Timely communication of test results defined as timely identification of abnormal test results with timely follow-up. | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral Loop | Yes | N/A |
| Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology. | ||
| Invasive Procedure or Surgery Anticoagulation Medication Management | Yes | N/A |
| For an anticoagulated patient undergoing a planned invasive procedure for which interruption in anticoagulation is anticipated, including patients taking vitamin K antagonists (warfarin), target specific oral anticoagulants (such as apixaban, dabigatran, and rivaroxaban), and heparins/low molecular weight heparins, documentation, including through the use of electronic tools, that the plan for anticoagulation management in the periprocedural period was discussed with the patient and with the clinician responsible for managing the patient’s anticoagulation. Elements of the plan should include the following: discontinuation, resumption, and, if applicable, bridging, laboratory monitoring, and management of concomitant antithrombotic medications (such as antiplatelets and nonsteroidal anti-inflammatory drugs (NSAIDs)). An invasive or surgical procedure is defined as a procedure in which skin or mucous membranes and connective tissue are incised, or an instrument is introduced through a natural body orifice. | ||
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1609842715, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
SANTA MONICA, CA 90403
SANTA MONICA, CA 90403
SANTA MONICA, CA 90403
SANTA MONICA, CA 90403
SANTA MONICA, CA 90403
SANTA MONICA, CA 90403
SANTA MONICA, CA 90403
SANTA MONICA, CA 90403
SANTA MONICA, CA 90403
SANTA MONICA, CA 90403
SANTA MONICA, CA 90403
SANTA MONICA, CA 90403
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1609842715, enumerated as an "individual" on February 28, 2006.
The provider is located at 2811 WILSHIRE BLVD SUITE 840 SANTA MONICA, CA 90403 and the phone number is (310) 694-8300.
Neurological Surgery with taxonomy code 207T00000X.
