Individual provider Active NPI

Jose Daniel Martinez-Gamba, MD

  • Child & Adolescent Psychiatry Physician
  • Colorado Springs, CO
National Provider Identifier
1285935262
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
DR0052975 Issued in CO
Practice address
1795 Jet Wing Dr
Colorado Springs, CO 80916-2332
Phone
(719) 572-6100
Fax
(719) 572-6186
NPI assigned
Nov 8, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X DR0052975 CO Primary

Addresses

Primary practice location

1795 Jet Wing Dr
Colorado Springs, CO 80916-2332

Mailing address

1795 Jet Wing Dr
Colorado Springs, CO 80916-2332
Phone (719) 572-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20140213001107 CO Practitioner - Psychiatry 4880823996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diversus Health IncGroup PAC ID 7719879204, 49 clinicians

Practice addresses (Care Compare)

115 S Parkside Dr
Colorado Springs, CO 80910-3130
Phone (719) 572-6100

179 S Parkside Dr
Colorado Springs, CO 80910-3130
Phone (719) 572-6100

1795 Jet Wing Dr
Colorado Springs, CO 80916-2332
Phone (719) 572-6100

6208 Lehman Dr
Colorado Springs, CO 80918-8408
Phone (719) 572-6100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Diversus Health Inc Current Accepting new patients
Diversus Health Inc CurrentSince Sep 11, 2017 Accepting new patients
Diversus Health Inc CurrentSince Sep 11, 2017 Accepting new patients

Locations

460 County Road 43
Ste 7
Bailey, CO 80421
Phone (303) 838-5013

328 10th St
Calhan, CO 80808

179 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 572-6300

115 S Parkside Dr
Colorado Springs, CO 80910
Phone (719) 572-6340

413 Security Blvd
Colorado Springs, CO 80911

220 Ruskin Dr
Colorado Springs, CO 80910
Phone (719) 572-6150

6208 Lehman Dr
Colorado Springs, CO 80918
Phone (719) 572-6133

1795 Jet Wing Dr
Colorado Springs, CO 80916
Phone (719) 572-6111

875 W Moreno Ave
Colorado Springs, CO 80905
Phone (719) 572-6200

18401 Highway 24
Ste 119
Woodland Park, CO 80863

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1285935262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1795 JET WING DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809162332",
            "telephone_number": "719-572-6100",
            "fax_number": "719-572-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1795 JET WING DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809162332",
            "telephone_number": "719-572-6100",
            "fax_number": "719-572-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ-GAMBA",
        "first_name": "JOSE",
        "middle_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-08",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CO",
            "license": "DR0052975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.