Individual provider Active NPI

Fiel Donquila Gamad, FNP-C, PMHNP-BC

  • Family Nurse Practitioner
  • Modesto, CA
National Provider Identifier
1114342805
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95000474 Issued in CA
Practice address
1130 Coffee Rd Ste 10
Modesto, CA 95355-4228
Phone
(559) 624-6090
NPI assigned
Mar 4, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN 676426 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95000474 CA
Family Nurse Practitioner 363LF0000X 95000474 CA Primary

Addresses

Primary practice location

1130 Coffee Rd Ste 10
Modesto, CA 95355-4228

Mailing address

3916 Lakeside Dr
Modesto, CA 95355-7312
Phone (559) 495-8659

Other practice location 1

1225 W 190th St Ste 280
Gardena, CA 90248-4305
Phone (877) 515-8113

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140514002260 CA Practitioner - Nurse Practitioner 7012130396 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aspen Family Medical Group of Modesto, Inc.Group PAC ID 4183615248, 4 clinicians

Practice addresses (Care Compare)

1130 Coffee Rd
Suite 10
Modesto, CA 95355-4228
Phone (209) 522-9054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN 676426CAMDRegistered Nurse
95000474CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-California CurrentSince Jul 1, 2014 Accepting new patients
Kaweah Delta Health Care District CurrentSince Jul 1, 2014 Accepting new patients
Ehab Yacoub MD Inc. CurrentSince Jul 17, 2023 Accepting new patients
Long Term Care Medical Group, Inc CurrentSince Nov 11, 2018 Accepting new patients
Pinnacle Emergency Physicians of Bakersfield, a Professional Corp CurrentSince Jan 1, 2015 Accepting new patients
Memory Check Psychological Services, a Professional Corporation Psychiatric/Mental Health CurrentSince Jan 2, 2024 Accepting new patients
Kaweah Delta Health Care District CurrentSince Jan 25, 2015 Accepting new patients
Aspen Family Medical Group of Modesto, Inc. CurrentSince Jan 11, 2021 Accepting new patients
Cep America - California CurrentSince Jul 1, 2014 Accepting new patients
Kaweah Delta Health Care District CurrentSince Jul 1, 2014 Accepting new patients
Kaweah Delta Health Care District Current Accepting new patients
Pinnacle Emergency Physicians of Bakersfield, a Professional Corp CurrentSince Jan 1, 2015 Accepting new patients
Cep America - California Current Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

5838 Edison Pl
Ste 100
Carlsbad, CA 92008
Phone (760) 300-3664

17777 Center Court Dr N
Ste 600
Cerritos, CA 90703
Phone (562) 354-3099

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

685 W Alluvial Ave
Ste 103
Fresno, CA 93711
Phone (559) 274-6444

925 N Cornelia Ave
Fresno, CA 93706
Phone (559) 275-4785

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113

1130 Coffee Rd
Ste 10
Modesto, CA 95355
Phone (209) 312-9865

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929

348 Iris Dr
Salinas, CA 93906
Phone (831) 449-5496

7447 Sepulveda Blvd
Van Nuys, CA 91405
Phone (818) 787-3400

1633 S Court St
Visalia, CA 93277
Phone (559) 624-6090

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

840 S Akers St
Visalia, CA 93277
Phone (559) 624-3700

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1114342805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3916 LAKESIDE DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953557312",
            "telephone_number": "559-495-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 COFFEE RD STE 10",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554228",
            "telephone_number": "559-624-6090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 W 190th St Ste 280",
            "address_purpose": "LOCATION",
            "city": "Gardena",
            "state": "CA",
            "postal_code": "902484305",
            "country_code": "US",
            "telephone_number": "877-515-8113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAMAD",
        "first_name": "FIEL",
        "middle_name": "DONQUILA",
        "credential": "FNP-C, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-04",
        "last_updated": "2024-05-02",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN 676426",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95000474",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.