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GABRIEL POLIBOY M.D.
NPI 1821401605
Pediatrics in Los Angeles, CA

Active since June 09, 2014PECOS Enrolled
4650 W SUNSET BLVD, LOS ANGELES, CA 90027(323) 361-2113 Get Directions Write a Review

NPPES record last updated: December 17, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Gabriel Poliboy M.d. NPPES

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

GABRIEL POLIBOY M.D. (NPI 1821401605) is an individual pediatrics provider in Los Angeles, California, licensed in California (A124445) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1821401605
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameGABRIEL POLIBOYCredential: M.D.
Location Address4650 W SUNSET BLVDLos Angeles, CA 90027-6062
Mailing Address4650 W Sunset BlvdLos Angeles, CA 90027-6062 · (323) 361-2113
Phone(323) 361-2113
Sole ProprietorNo
Enumeration DateJune 9, 2014
Last NPPES UpdateDecember 17, 2021
✔ NPI 1821401605 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A124445
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.
4650 W SUNSET BLVD, Los Angeles, CA 90027
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gabriel Poliboy M.d. 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.

Medicare Billing Reassignment

Medicare enrollment records show Gabriel Poliboy reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
305 mi
Internal Medicine
710 LAWRENCE EXPRESSWAY
Santa Clara, CA 95051
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1073606299 (408) 851-1000

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90027 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 20

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

DR. MARK HENDRIK CORDEN M.D.
Pediatrics
4650 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (323) 361-8893
MS. ROBERTA MIYEKO KATO MD
Pediatrics (Pediatric Pulmonology)
4650 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (323) 361-2101
CHILDREN'S HOSPITAL LOS ANGELES
General Acute Care Hospital (Children)
4650 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (323) 361-3644
JESSICA ELIZABETH GREIM DPT, PT
Physical Therapist (Pediatrics)
4650 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (310) 361-2118
MOLLY CEVASCO PH.D., BCBA
Psychologist (Clinical Child & Adolescent)
4650 W SUNSET BLVD, MS #53
LOS ANGELES, CA 90027
Los Angeles County (323) 361-3849
GINNY KIM THAN NP
Nurse Practitioner (Pediatrics)
4650 W SUNSET BLVD, MS #81
LOS ANGELES, CA 90027
Los Angeles County (323) 361-3033
DOUGLAS SHAPIRO MD
Pediatrics (Pediatric Emergency Medicine)
4650 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (323) 660-2450
ALEXANDRA LYNN JOSTES MD
Student in an Organized Health Care Education/Training Program
4650 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (323) 361-2122

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 Gabriel Poliboy's NPI number?

The NPI number for Gabriel Poliboy is 1821401605. It was assigned to this individual provider in the NPPES registry on June 9, 2014.

Where is Gabriel Poliboy located?

Gabriel Poliboy practices at 4650 W Sunset Blvd, Los Angeles, CA 90027. The listed phone number is (323) 361-2113.

What is Gabriel Poliboy's specialty?

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

Is Gabriel Poliboy enrolled in Medicare?

Yes. Gabriel Poliboy is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Gabriel Poliboy's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gabriel Poliboy reassigns Medicare benefits to Permanente Medical Group Inc (Santa Clara, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gabriel Poliboy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Gabriel Poliboy was last updated on December 17, 2021. 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.