Individual provider Active NPI

Elmer Salvador Gamboa, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Pennington, NJ
National Provider Identifier
1205973666
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
25MA06897600 Issued in NJ
Practice address
1 Capital Way
Pennington, NJ 08534-2520
Phone
(609) 815-7810
NPI assigned
Feb 1, 2007
Last updated
May 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 25MA06897600 NJ Primary

Addresses

Primary practice location

1 Capital Way
Pennington, NJ 08534-2520

Mailing address

1 Capital Way
Pathology Department
Pennington, NJ 08534-2520
Phone (609) 303-6000

Other practice location 1

17 Heritage Dr
South River, NJ 08882-2593
Phone (732) 390-8341

Other identifiers 1

IdentifierTypeStateIssuer
8409501MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Elmer.Gamboa@capitalhealth.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20111128000703 NJ Practitioner - Pathology 7810161007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Health Medical GroupGroup PAC ID 7618264532, 442 clinicians

Practice addresses (Care Compare)

1 Capital Way
Pennington, NJ 08534-2520
Phone (609) 303-4244

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.91 of 100Reported as apm
Quality
79.42
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Health Medical Group CurrentSince Mar 1, 2019 Accepting new patients
Karel Raska Jr MD - Modern Diagnostics Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

3131 Princeton Pike
Bldg 5
Lawrenceville, NJ 08648
Phone (609) 844-9661

1 Capital Way
Pennington, NJ 08534
Phone (609) 303-4000

1700 Nottingham Way
Ste 108
Trenton, NJ 08619
Phone (609) 303-4870

Interoperability endpoints

  • Direct secure messaging: elmer.gamboa@capitalhealth.cernerdirect.com
  • FHIR API: https://api.platform.athenahealth.com/12833/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1205973666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CAPITAL WAY",
            "address_2": "PATHOLOGY DEPARTMENT",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085342520",
            "telephone_number": "609-303-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CAPITAL WAY",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085342520",
            "telephone_number": "609-815-7810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 Heritage Dr",
            "address_purpose": "LOCATION",
            "city": "South River",
            "state": "NJ",
            "postal_code": "088822593",
            "country_code": "US",
            "telephone_number": "732-390-8341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAMBOA",
        "first_name": "ELMER",
        "middle_name": "SALVADOR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "25MA06897600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8409501",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Elmer.Gamboa@capitalhealth.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Capital Way",
            "city": "Pennington",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "085342520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pennington, NJ

Sources for this page

Verify at the official NPI Registry.