Individual provider Active NPI

Tobin C Gallawa, DPM

  • Podiatrist
  • Sacramento, CA
National Provider Identifier
1316942634
Registry record updated May 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E4375 Issued in CA
Practice address
2322 Butano Dr
Suite 110
Sacramento, CA 95825-0687
Phone
(916) 488-8750
Fax
(916) 488-7767
NPI assigned
Jun 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E4375 CA Primary

Addresses

Primary practice location

2322 Butano Dr
Suite 110
Sacramento, CA 95825-0687

Mailing address

2322 Butano Dr
Suite 110
Sacramento, CA 95825-0687
Phone (916) 488-8750

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100611000269 CA Practitioner - Podiatry 2062542491 Practice locations: Sacramento, CA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2322 Butano Dr
Suite 110
Sacramento, CA 95825-0687
Phone (916) 488-8750

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue456
Removal or shaving of skin growth201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4375CAMDPodiatrist
1265TXMDElectroneurodiagnostic Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter North Medical Foundation Past Accepting new patients
Chca Conroe LP Past Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495411200000",
    "number": "1316942634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2322 BUTANO DR",
            "address_2": "SUITE 110",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958250687",
            "telephone_number": "916-488-8750",
            "fax_number": "916-488-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2322 BUTANO DR",
            "address_2": "SUITE 110",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958250687",
            "telephone_number": "916-488-8750",
            "fax_number": "916-488-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAWA",
        "first_name": "TOBIN",
        "middle_name": "C",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2017-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.