NPIMap

Individual provider Active NPI

David R Gotham Jr., DO

  • Orthopaedic Surgery Physician
  • Rocklin, CA
National Provider Identifier
1023009297
Registry record updated Apr 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
20A8894 Issued in CA
Practice address
2204 Plaza Dr
Suite 210
Rocklin, CA 95765-4413
Phone
(916) 771-9555
Fax
(916) 771-9556
NPI assigned
Nov 4, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 20A8894 CA Primary

Addresses

Primary practice location

2204 Plaza Dr
Suite 210
Rocklin, CA 95765-4413

Mailing address

2204 Plaza Dr
Suite 210
Rocklin, CA 95765-4413
Phone (916) 771-9555

Other identifiers 1

IdentifierTypeStateIssuer
00AX88940MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040903000534 CA Practitioner - Orthopedic Surgery 6002882719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
New York Medical College, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2204 Plaza Dr
Rocklin, CA 95765-4413
Phone (916) 771-9555

Hospital & facility affiliations

  • Precise Med, LLC Home health agency, Roseville, CA, CCN 757755
  • Advanced Home Health, Inc Home health agency, Sacramento, CA, CCN 058426
  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309
  • Sutter Auburn Faith Hospital Hospital, Auburn, CA, CCN 050498
  • Sierra Nevada Memorial Hospital Hospital, Grass Valley, CA, CCN 050150

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)19
Upper limb (arm) arthroscopy (minimally invasive joint repair)42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
8894CAMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
David R. Gotham, Jr., D.O., Incorporated Orthopaedic Surgery CurrentSince Jan 1, 2008 Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Dignity Health Past Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients

Locations

6620 Coyle Ave
Ste 212
Carmichael, CA 95608
Phone (916) 536-9455

2204 Plaza Dr
Ste 210
Rocklin, CA 95765
Phone (916) 771-9555

2204 Plaza Dr
Ste 120
Rocklin, CA 95765
Phone (916) 771-9555

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239062400000",
    "number": "1023009297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 PLAZA DR",
            "address_2": "SUITE 210",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957654413",
            "telephone_number": "916-771-9555",
            "fax_number": "916-771-9556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 PLAZA DR",
            "address_2": "SUITE 210",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957654413",
            "telephone_number": "916-771-9555",
            "fax_number": "916-771-9556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTHAM",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2009-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "20A8894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX88940",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocklin, CA

Sources for this page

Verify at the official NPI Registry.