Active NPI
Gwendolyn Marie Scurka, N.P.
- Family Medicine Physician
- Roseville, CA
National Provider Identifier
1396825220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 16718
- Practice address
- 508 Gibson Dr
Suite 110
Roseville, CA 95678-5794 - Phone
- (916) 783-1080
- Fax
- (916) 783-1090
- NPI assigned
- Oct 16, 2006
- Last updated
- Sep 29, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 16718 | CA | Primary |
Addresses
Primary practice location
508 Gibson Dr
Suite 110
Roseville, CA 95678-5794
Mailing address
1643 Wortell Dr
Lincoln, CA 95648-3113
Phone (916) 783-1080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rocklin Family Practice and Sports Medicine | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- gscurka339581@hisp.ehr.sutterhealth.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Rocklin, CA
- NPI 1790798908
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411948800000",
"number": "1396825220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1643 WORTELL DR",
"city": "LINCOLN",
"state": "CA",
"postal_code": "956483113",
"telephone_number": "916-783-1080",
"fax_number": "916-783-1090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "508 GIBSON DR",
"address_2": "SUITE 110",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956785794",
"telephone_number": "916-783-1080",
"fax_number": "916-783-1090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCURKA",
"first_name": "GWENDOLYN",
"middle_name": "MARIE",
"name_prefix": "Miss",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-16",
"last_updated": "2014-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "16718",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roseville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.