Individual provider Active NPI

Andrew D Gamache, DDS

  • Sleep Medicine (Family Medicine) Physician
  • San Diego, CA
National Provider Identifier
1043317720
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Family Medicine) PhysicianTaxonomy code 207QS1201X
License
54255 Issued in CA
Practice address
306 Walnut Ave
San Diego, CA 92103-4978
Phone
(619) 220-0866
Fax
(619) 220-0870
NPI assigned
Sep 17, 2006
Last updated
Aug 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 23448 TX
General Practice Dentistry 1223G0001X 54255 CA
Sleep Medicine (Family Medicine) Physician 207QS1201X 54255 CA Primary

Addresses

Primary practice location

306 Walnut Ave
San Diego, CA 92103-4978

Mailing address

306 Walnut Ave Ste 31
San Diego, CA 92103-4936
Phone (619) 220-0866

Other practice location 1

5414 Oberlin Dr Ste 235
San Diego, CA 92121-4744
Phone (858) 617-0660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230913003023 CA Practitioner - Dentist 2163895137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
University of Southern California Keck School of Medicine, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5414 Oberlin Dr
Suite 235
San Diego, CA 92121-4744
Phone (619) 220-0866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23448TXMDGeneral Practice Dentistry
54255CAMDSleep Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Sleep Solutions San Diego, Inc. General Practice CurrentSince Dec 9, 2022 Accepting new patients
Rohatgi Dental Corp Past Accepting new patients

Locations

5414 Oberlin Dr
Ste 235
San Diego, CA 92121
Phone (619) 220-0866

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1043317720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 WALNUT AVE STE 31",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034936",
            "telephone_number": "619-220-0866",
            "fax_number": "619-220-0870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 WALNUT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034978",
            "telephone_number": "619-220-0866",
            "fax_number": "619-220-0870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5414 Oberlin Dr Ste 235",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921214744",
            "country_code": "US",
            "telephone_number": "858-617-0660",
            "fax_number": "858-617-0661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAMACHE",
        "first_name": "ANDREW",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23448",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54255",
            "primary": false
        },
        {
            "code": "207QS1201X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sleep Medicine",
            "state": "CA",
            "license": "54255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.