Individual provider Active NPI

Gary James Gage, O.D.

  • Optometrist
  • Gonzales, TX
National Provider Identifier
1376544635
Registry record updated Jan 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2776TG Issued in TX
Practice address
305 Saint Lawrence St
#1598
Gonzales, TX 78629-3935
Phone
(830) 672-6521
Fax
(830) 672-6785
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2776TG TX Primary

Addresses

Primary practice location

305 Saint Lawrence St
#1598
Gonzales, TX 78629-3935

Mailing address

808 Saint Vincent St
Gonzales, TX 78629-4624
Phone (830) 672-6293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20101014000824 TX Practitioner - Optometry 5395937973 Practice locations: Gonzales, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2776TGTXMDOptometrist
2776TXMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gary J Gage CurrentSince Sep 1, 1980 Accepting new patients

Locations

305 Saint Lawrence St
#1598
Gonzales, TX 78629
Phone (830) 672-6521

305 Saint Lawrence St
Gonzales, TX 78629
Phone (830) 672-6521

Organizations & group practices 1

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420675200000",
    "number": "1376544635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 SAINT VINCENT ST",
            "city": "GONZALES",
            "state": "TX",
            "postal_code": "786294624",
            "telephone_number": "830-672-6293",
            "fax_number": "830-672-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 SAINT LAWRENCE ST",
            "address_2": "#1598",
            "city": "GONZALES",
            "state": "TX",
            "postal_code": "786293935",
            "telephone_number": "830-672-6521",
            "fax_number": "830-672-6785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGE",
        "first_name": "GARY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2015-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2776TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gonzales, TX

Sources for this page

Verify at the official NPI Registry.