Organization Active NPI

Gopal Reddy Gade M.D. Inc

  • Obstetrics & Gynecology Physician
  • Fresno, CA
National Provider Identifier
1396778437
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A35041 Issued in CA
Legal business name
GOPAL REDDY GADE M.D. INC
Practice address
6183 N Fresno St
Ste 105
Fresno, CA 93710-8611
Phone
(559) 261-0794
Fax
(559) 261-0797
NPI assigned
Jul 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Authorized official

Name
Eileen G Robles
Title
Office Manager
Phone
(559) 261-0794

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X A35041 CA Primary

Addresses

Primary practice location

6183 N Fresno St
Ste 105
Fresno, CA 93710-8611

Mailing address

6183 N. Fresno St
Suite 105
Fresno, CA 93710
Phone (559) 261-0794

Other identifiers 1

IdentifierTypeStateIssuer
00A350410MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090626000260 CA Part B Supplier - Clinic/Group Practice 3274684576 Receives reassigned benefits from 1 practitioner
Practice locations: Fresno, CA

National Provider Directory

National Provider Directory

Locations

6183 N Fresno St
Ste 105
Fresno, CA 93710
Phone (559) 261-0794

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349308800000",
    "number": "1396778437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6183 N. FRESNO ST",
            "address_2": "SUITE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93710",
            "telephone_number": "559-261-0794",
            "fax_number": "559-261-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6183 N FRESNO ST",
            "address_2": "STE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937108611",
            "telephone_number": "559-261-0794",
            "fax_number": "559-261-0797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOPAL REDDY GADE M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2012-10-04",
        "status": "A",
        "authorized_official_last_name": "ROBLES",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "559-261-0794"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A35041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A350410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.