Gayle Fenner, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

52252 Issued in CA

Practice address

2625 Shadelands Dr
Walnut Creek, CA 94598-2512

Phone

(925) 939-8585

Fax

(925) 933-2709

NPI assigned

Jan 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Golden State Orthopedics and SpineGroup PAC ID 8224940739, 186 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• John Muir Medical Center - Walnut Creek Campus Hospital, Walnut Creek, CA, CCN 050180
• John Muir Medical Center - Concord Campus Hospital, Concord, CA, CCN 050496

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gayle.fenner@direct.muirortho.nextgenshare.com

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.

• Golden State Orthopedics & Spine

  • Orthopaedic Surgery Physician
  • Walnut Creek, CA
  • NPI 1972552990
  Medicare reassignment Care Compare group
• Golden State Orthopedics & Spine

  • Orthopaedic Surgery Physician
  • San Jose, CA
  • NPI 1245021401
  NPD
• Golden State Orthopedics & Spine

  • Orthopaedic Surgery Physician
  • Oakland, CA
  • NPI 1528711959
  NPD
• Golden State Orthopedics & Spine

  • Orthopaedic Surgery Physician
  • San Francisco, CA
  • NPI 1457004897
  NPD (past)

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

• John Muir Health

  • General Acute Care Hospital
  • Walnut Creek, CA
  • NPI 1740215219
  Care Compare affiliation
• John Muir Health

  • General Acute Care Hospital
  • Concord, CA
  • NPI 1801821376
  Care Compare affiliation

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

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1255720025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31396",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945988396",
            "telephone_number": "925-939-8585",
            "fax_number": "925-933-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 SHADELANDS DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982512",
            "telephone_number": "925-939-8585",
            "fax_number": "925-933-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNER",
        "first_name": "GAYLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-16",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52252",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "52252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Felix Morales
• Felixkalmanddsinc
• Alexandra Paige Fellman
• Alice Feng
• Fenix2022 Transportation LLC
• Daniel Fenton
• Robert Alan Feren, M.D.
• Tara Fernandes
• Kimberly Fernandez
• Oscar Fernandez, MD

• Surgical Physician Assistant in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.