Lance Gator Gault, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A10128 Issued in CA

Practice address

2740 Herndon Ave
Clovis, CA 93611-6813

Phone

(559) 299-2608

Fax

(559) 299-1341

NPI assigned

Aug 24, 2007

Last updated

Jan 19, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Family PracticeAlso: Emergency Medicine

Education

College of Osteo Med of the Pacific at Pomona, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kaiser Foundation Hospital - Fresno Hospital, Fresno, CA, CCN 050710

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment Care Compare group
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1841373800

  Family Medicine

  NPD
• Lumira Healthcare

  dba Modesto Florida Ave Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1649099151
  NPD (past)
• Vepema Medical Group

  • Emergency Medicine Physician
  • Turlock, CA
  • NPI 1356502496
  NPD (past)

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

• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Fresno

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1083784672
  Care Compare affiliation

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1164615811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 HERNDON AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116813",
            "telephone_number": "559-299-2608",
            "fax_number": "559-299-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 HERNDON AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116813",
            "telephone_number": "559-299-2608",
            "fax_number": "559-299-1341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAULT",
        "first_name": "LANCE",
        "middle_name": "GATOR",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-24",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A10128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7300 N Fresno St",
            "city": "Fresno",
            "state": "CA",
            "country_code": "US",
            "postal_code": "937202941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Diana Gasparyan, CFY-SLP
• Melissa R Gaston
• Aphrodite Josephine Gates I
• Gateway Care Center LLC
• Gateway High Schol
• Samuel A Gebretsadik
• Richard J Geller, MD
• Genesis Rehab Services
• Genialcare LLC
• Shelly Gerken, SPT

• Family Medicine Physician in Clovis, CA
• Providers in Clovis, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.