Individual provider Active NPI

Charles Eric Gage, MD

  • Otolaryngology Physician
  • Roseville, CA
National Provider Identifier
1053404970
Registry record updated Jun 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A41200 Issued in CA
Practice address
3 Medical Plaza Dr
#220
Roseville, CA 95661-3087
Phone
(916) 773-7970
Fax
(916) 773-7919
NPI assigned
Oct 2, 2006
Last updated
Jun 3, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A41200 CA Primary

Addresses

Primary practice location

3 Medical Plaza Dr
#220
Roseville, CA 95661-3087

Mailing address

10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (866) 681-0736

Other identifiers 1

IdentifierTypeStateIssuer
00A412000MedicaidCA

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080717000324 CA Practitioner - Otolaryngology 0345313706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone (916) 454-6868

2800 L St
Sacramento, CA 95816-5616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A41200CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Otolaryngology Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Feb 1, 2000 Accepting new patients
Sutter Valley Medical Foundation Otolaryngology CurrentSince Feb 1, 2000 Accepting new patients

Locations

3 Medical Plaza Dr
Ste 220
Roseville, CA 95661
Phone (916) 773-7920

10470 Old Placerville Rd
Ste 100
Sacramento, CA 95827

2750 Gateway Oaks Dr
Ste 150
Sacramento, CA 95833
Phone (916) 887-7398

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: egagemd13310@hisp.ehr.sutterhealth.org

Organizations & group practices 3

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1053404970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "866-681-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MEDICAL PLAZA DR",
            "address_2": "#220",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613087",
            "telephone_number": "916-773-7970",
            "fax_number": "916-773-7919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGE",
        "first_name": "CHARLES",
        "middle_name": "ERIC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A41200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A412000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.