Kimberly Dyanne Gaudi, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5071 Issued in CA

Practice address

4421 47TH St
San Diego, CA 92115-4516

Phone

(619) 280-3200

NPI assigned

Jan 22, 2020

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Euclid Physical Therapy, Inc.Group PAC ID 3577607068, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Euclid Physical Therapy, Inc.

  • Physical Therapist
  • San Diego, CA
  • NPI 1871821918
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1124658729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 47TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154516",
            "telephone_number": "619-280-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 47TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154516",
            "telephone_number": "619-280-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUDI",
        "first_name": "KIMBERLY",
        "middle_name": "DYANNE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-22",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "5071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA OT LICENSE",
            "identifier": "5071",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA DRIVER'S LICENSE",
            "identifier": "D2092568",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Galen Harold Gattis, FNP-C
• Linda S. Gatto-Woitek, LCSW
• Luisa Gatto
• Radharani Gattu, MD
• James W. Gaudet, MD
• Alanah Gaudreau
• Philip Adrien Gaudreau III, M.D.
• Jenna Gaugh
• Lindsay Gaughran
• Lindsay Gaugler, NUTRITION COACH

• Occupational Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.