Individual provider Active NPI

Gwendolyn Marie Scurka, N.P.

  • Family Medicine Physician
  • Roseville, CA
National Provider Identifier
1396825220
Registry record updated Sep 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16718 Issued in CA
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, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

OrganizationSpecialtyStatusNew patients
Rocklin Family Practice and Sports Medicine Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.