Individual provider Active NPI

Tesfaye Gebrekristos Gondel, MD

  • Pediatrics Physician
  • San Jose, CA
National Provider Identifier
1639110562
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A94161 Issued in CA
Practice address
751 S Bascom Ave
Psychiatry Department
San Jose, CA 95128-2604
Phone
(408) 885-6100
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A94161 CA Primary

Addresses

Primary practice location

751 S Bascom Ave
Psychiatry Department
San Jose, CA 95128-2604

Mailing address

10200 Miller Ave
Cupertino, CA 95014-3439
Phone (917) 755-1054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111107000223 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 1153328554

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrix Medical Group of California, a Professional Corporation Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tgondel125692@santaclaravalley.direct-ci.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1639110562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 MILLER AVE",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950143439",
            "telephone_number": "917-755-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "address_2": "PSYCHIATRY DEPARTMENT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604",
            "telephone_number": "408-885-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONDEL",
        "first_name": "TESFAYE",
        "middle_name": "GEBREKRISTOS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A94161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.