NPIMap

Individual provider Active NPI

Gatbel Nyak Chamjock, PA

  • Medical Physician Assistant
  • Waterloo, IA
National Provider Identifier
1649454281
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
076828 Issued in IA
Practice address
1825 Logan Ave
Waterloo, IA 50703
Phone
(319) 235-3697
NPI assigned
Dec 18, 2007
Last updated
Oct 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2461 CO
Medical Physician Assistant 363AM0700X 1679 NE
Medical Physician Assistant 363AM0700X 076828 IA Primary

Addresses

Primary practice location

1825 Logan Ave
Waterloo, IA 50703

Mailing address

1825 Logan Ave
Waterloo, IA 50703-1916
Phone (319) 235-3697

Other practice location 1

4021 Avenue B
Scottsbluff, NE 69361-4602
Phone (970) 521-8860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150427001779 IA Practitioner - Physician Assistant 6103077557 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1679NEMDFamily Medicine Physician
2461COMDPhysical Rehabilitation Occupational Therapist
076828IAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stewart Memorial Community Hospital Physician Assistant CurrentSince Dec 28, 2025 Accepting new patients
Trinity Regional Medical Center CurrentSince Jul 15, 2025 Accepting new patients
Salahuddin Syed MD PC Current Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Unitypoint Health - Marshalltown CurrentSince Dec 15, 2018 Accepting new patients
Unitypoint Health - Marshalltown CurrentSince Dec 15, 2018 Accepting new patients
Allen Memorial Hospital Corporation Physician Assistant CurrentSince Apr 6, 2015 Accepting new patients
Stewart Memorial Community Hospital CurrentSince Dec 28, 2025 Accepting new patients
Stewart Memorial Community Hospital Physician Assistant Past Accepting new patients

Locations

802 Kenyon Rd
Fort Dodge, IA 50501
Phone (515) 574-6565

1301 W Main St
Lake City, IA 51449
Phone (712) 464-3171

55 Unitypoint Way
Marshalltown, IA 50158
Phone (641) 754-5145

1825 Logan Ave
Waterloo, IA 50703
Phone (319) 235-3886

Interoperability endpoints

  • Direct secure messaging: gchamjock242600@direct.unitypoint.org
  • Direct secure messaging: gchamjock3930818@direct.trinity-health.org

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1649454281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 LOGAN AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031916",
            "telephone_number": "319-235-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 LOGAN AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "50703",
            "telephone_number": "319-235-3697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4021 Avenue B",
            "address_purpose": "LOCATION",
            "city": "Scottsbluff",
            "state": "NE",
            "postal_code": "693614602",
            "country_code": "US",
            "telephone_number": "970-521-8860",
            "fax_number": "970-521-8225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAMJOCK",
        "first_name": "GATBEL",
        "middle_name": "NYAK",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-18",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "2461",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "1679",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "076828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.