Gavin Kolodge

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

20A18281 Issued in CA

Practice address

9095 Rio San Diego Dr Ste 450
San Diego, CA 92108-1726

Phone

(619) 853-8860

NPI assigned

Apr 5, 2016

Last updated

Jan 12, 2026By the provider in NPPES

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

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

Specialty

Physical Medicine and Rehabilitation

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Synergy Orthopedic Specialists IncGroup PAC ID 0941450498, 66 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Synergy Orthopedic Specialists, Inc.

  • Specialist
  • San Diego, CA
  • NPI 1114282779
  Medicare reassignment Care Compare group NPD
• Synergy Orthopedic Specialists, Inc.

  • Specialist
  • Temecula, CA
  • NPI 1194447888
  NPD
• Synergy Surgery Center of San Diego LLC

  • Ambulatory Surgical Clinic/Center
  • San Diego, CA
  • NPI 1043062870
  NPD (past)

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1407210537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9095 RIO SAN DIEGO DR STE 410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081679",
            "telephone_number": "858-357-9450",
            "fax_number": "858-412-6376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9095 RIO SAN DIEGO DR STE 450",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081726",
            "telephone_number": "619-853-8860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "955 Lane Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Chula Vista",
            "state": "CA",
            "postal_code": "919144525",
            "country_code": "US",
            "telephone_number": "619-421-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLODGE",
        "first_name": "GAVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-05",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "20A18281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tarina Frances Ann Kollars, LMFT
• Vijay S. Kollengode, M.D.
• Regina Lynn Koller, LPCC, CADC-II
• Aditya Kollipara
• Nancy Ruth Kollisch, M.D.
• Alice Kolodji, NP
• David J Kolodji, CRNA
• Rebecca A Kolodner, MD
• Elizabeth Ann Kolodzey, O.D.
• Michael Kevin Kolodziej, MFT

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.