Active NPI
Gilbert Eggen, DO
- Psychiatry Physician
- Modesto, CA
National Provider Identifier
1588742498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 20A4510
- Practice address
- 3509 Coffee Rd
Ste D18
Modesto, CA 95355-1358 - Phone
- (209) 523-7297
- Fax
- (209) 523-7299
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 20A4510 | CA | Primary |
Addresses
Primary practice location
3509 Coffee Rd
Ste D18
Modesto, CA 95355-1358
Mailing address
3509 Coffee Rd
Ste D18
Modesto, CA 95355-1358
Phone (209) 523-7297
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050729000605 | CA | Practitioner - Psychiatry | 6709814858 | Practice locations: Modesto, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 1978
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3509 Coffee Rd
Suite D18
Modesto, CA 95355-1358
Phone (209) 523-7297
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A4510 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495756800000",
"number": "1588742498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3509 COFFEE RD",
"address_2": "STE D18",
"city": "MODESTO",
"state": "CA",
"postal_code": "953551358",
"telephone_number": "209-523-7297",
"fax_number": "209-523-7299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3509 COFFEE RD",
"address_2": "STE D18",
"city": "MODESTO",
"state": "CA",
"postal_code": "953551358",
"telephone_number": "209-523-7297",
"fax_number": "209-523-7299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EGGEN",
"first_name": "GILBERT",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2017-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "20A4510",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2017; 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.