David C Gorsulowsky, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

C42190 Issued in CA

Practice address

39210 State St
Ste 218
Fremont, CA 94538-1456

Phone

(510) 790-0477

Fax

(510) 790-1835

NPI assigned

Jun 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Dermatology

Education

Louisiana State University School of Medicine in New Orleans, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Csi Medical GroupGroup PAC ID 5890916845, 104 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Washington Hospital Hospital, Fremont, CA, CCN 050195

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: dgorsulowsky13526@direct.whhs.com

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.

• Csi Medical Group

  • MOHS-Micrographic Surgery Physician
  • San Pedro, CA
  • NPI 1871909804

  Dermatology

  Medicare reassignment Care Compare group NPD
• Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1437292927

  Dermatology

  Medicare reassignment NPD
• Stanford Health Care

  • Radiation Oncology Physician
  • Pleasanton, CA
  • NPI 1124561758
  NPD
• Stanford Health Care

  • Specialty Pharmacy
  • Mountain View, CA
  • NPI 1760366132
  NPD
• County of Santa Clara

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1063406551
  NPD (past)
• Washington Township Hospital District

  • General Acute Care Hospital
  • Fremont, CA
  • NPI 1154472058
  NPD (past)
• Upmc Washington

  • Rehabilitation Hospital Unit
  • Washington, PA
  • NPI 1427166602
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Washington Township Hospital District

  • General Acute Care Hospital
  • Fremont, CA
  • NPI 1780614685
  Care Compare affiliation

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1649272832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39210 STATE ST",
            "address_2": "STE 218",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381456",
            "telephone_number": "510-790-0477",
            "fax_number": "510-790-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39210 STATE ST",
            "address_2": "STE 218",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381456",
            "telephone_number": "510-790-0477",
            "fax_number": "510-790-1835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORSULOWSKY",
        "first_name": "DAVID",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "C042190",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "C42190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "943205645",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA LICENSE NUMBER",
            "identifier": "C42190",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NUMBER",
            "identifier": "070008967",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shobhana Gopalakrishnan, PT, DPT
• Sabrina Gordon
• Heather Gorena
• Silpa Goriparthi, MD
• Yo-Shian Gorman
• Sonia Gosain
• Casie Gott, BSN, RN
• Andrea Danielle Gottfried
• Lina S. Gourova, MD
• Natarajan Gowda, PH.D., LCSW

• Dermatology Physician in Fremont, CA
• Providers in Fremont, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.