Ingvild Benedicte Gasmann, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 17002 Issued in CA

Practice address

1440 168TH Ave
San Leandro, CA 94578-2409

Phone

(510) 481-3197

Fax

(510) 481-6327

NPI assigned

Dec 7, 2006

Last updated

Nov 26, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637884800000",
    "number": "1033278981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 168TH AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782409",
            "telephone_number": "510-481-3197",
            "fax_number": "510-481-6327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 168TH AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782409",
            "telephone_number": "510-481-3197",
            "fax_number": "510-481-6327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASMANN",
        "first_name": "INGVILD",
        "middle_name": "BENEDICTE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-07",
        "last_updated": "2021-11-26",
        "certification_date": "2021-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 17002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1440 168th Ave",
            "city": "San Leandro",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945782409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapist in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.