Dewey Jeffrey Duckham, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A036604 Issued in CA

Practice address

15251 National Ave. Suite 108
Los Gatos, CA 95032

Phone

(408) 358-3835

Fax

(408) 358-2765

NPI assigned

Jul 17, 2006

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

Other names 1

• Dr. Jeffrey Dewey Duckham Other name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431561600000",
    "number": "1356369508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15251 NATIONAL AVE.",
            "address_2": "SUITE 108",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "95032",
            "telephone_number": "408-358-3835",
            "fax_number": "408-358-2765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15251 NATIONAL AVE. SUITE 108",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "95032",
            "telephone_number": "408-358-3835",
            "fax_number": "408-358-2765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKHAM",
        "first_name": "DEWEY",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2015-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A036604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEFFREY",
            "last_name": "DUCKHAM",
            "middle_name": "DEWEY",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Maria Viktoria Drew, MA
• Douglas Drucker, PHD
• Alfredo Duarte Martinez, BCBA
• Cynthia Dubois Tabrisky, PT
• Alyx Michele Duckering
• Kirsten C Duggins, P.A., N.P.
• Sterling Elisabeth Duncan, CMT
• Vicki Lynn Duncan, MD
• Dara Dunham, L.AC.
• Colin Patrick Dunn, M.D.

• Family Medicine Physician in Los Gatos, CA
• Providers in Los Gatos, 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 May 14, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.