Individual provider Active NPI

Gaeton Thomas Nola, M.D.

  • Plastic Surgery Physician
  • Los Gatos, CA
National Provider Identifier
1629146147
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
G30729 Issued in CA
Practice address
15047 Los Gatos Blvd
Ste. 150
Los Gatos, CA 95032-2054
Phone
(408) 356-2244
Fax
(408) 395-4849
NPI assigned
Dec 1, 2006
Reactivated
Apr 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X G30729 CA Primary

Addresses

Primary practice location

15047 Los Gatos Blvd
Ste. 150
Los Gatos, CA 95032-2054

Mailing address

15047 Los Gatos Blvd
Ste. 150
Los Gatos, CA 95032-2054
Phone (408) 356-2244

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G30729CAMDPlastic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301961600000",
    "number": "1629146147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15047 LOS GATOS BLVD",
            "address_2": "STE. 150",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322054",
            "telephone_number": "408-356-2244",
            "fax_number": "408-395-4849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15047 LOS GATOS BLVD",
            "address_2": "STE. 150",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322054",
            "telephone_number": "408-356-2244",
            "fax_number": "408-395-4849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLA",
        "first_name": "GAETON",
        "middle_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2011-04-05",
        "deactivation_date": "2007-03-13",
        "reactivation_date": "2008-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "G30729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; 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.