Grace B. Gamponia, MD

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

MD00035568 Issued in WA

Practice address

4033 Talbot Rd S
Suite 570
Renton, WA 98055-5772

Phone

(425) 656-5400

Fax

(425) 656-5079

NPI assigned

Jun 30, 2006

Last updated

Mar 5, 2020By 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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Family Practice

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Valley Medical Group-RentonGroup PAC ID 4183753965, 419 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Haven Home Health Care Home health agency, Federal Way, WA, CCN 507132
• Valley Medical Center Hospital, Renton, WA, CCN 500088

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ggamponia6248@direct.valleymed.org

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.

• Valley Medical Group-Renton

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1619209574
  Medicare reassignment Care Compare group NPD
• Public Hospital District #1 of King County

  dba VMC Children's Therapy

  • Rehabilitation Hospital Unit
  • Renton, WA
  • NPI 1811063308
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Home Health Seattle LLC

  dba Choice Health at Home

  • Home Health Agency
  • Federal Way, WA
  • NPI 1033736160
  Care Compare affiliation
• Public Hospital District 1 of King County

  dba Valley Medical Center

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1649209230
  Care Compare affiliation
• Valley Medical Group-Renton

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1619209574
  Care Compare affiliation

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1164450748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 LIND AVE SW",
            "address_2": "SUITE 100 ATTN CREDENTIALING",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574970",
            "telephone_number": "425-690-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4033 TALBOT RD S",
            "address_2": "SUITE 570",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555772",
            "telephone_number": "425-656-5400",
            "fax_number": "425-656-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMPONIA",
        "first_name": "GRACE",
        "middle_name": "B.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "WA",
            "license": "MD00035568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043099",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - VALLEY MEDICAL GROUP",
            "identifier": "G8891427",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8227522",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Gallardo
• John Robert Gallip, EMT, NAR
• Christine Gruenheck Galloway
• Quisha Galloway, LICSW
• Ty Mitchell Galvin, D.D.S.
• Junyan Gan, O.D.
• Laura Ann Ganhs, PA-C
• Pamela E Ganz, PA-C
• Ashley Ganzberg, APRN, PMHNP-BC
• Lu Gao, M.D., PH.D.

• Adult Medicine Physician in Renton, WA
• Providers in Renton, WA by specialty
• Adult Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.