Gautami Agastya, MD., Inc.

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

License

A85126 Issued in CA

Legal business name

GAUTAMI AGASTYA, MD., INC.

Practice address

652 W 11TH St
Suite 137
Tracy, CA 95376-3869

Phone

(209) 833-7555

Fax

(209) 833-7518

NPI assigned

Feb 21, 2008

Last updated

Feb 13, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gautami Agastya, MDNPI 1356312516

Title

President

Phone

(209) 833-7555

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gautami Agastya, MD

  • Internal Medicine Physician
  • Tracy, CA
  • NPI 1356312516
  Medicare reassignment Care Compare group NPD Authorized official
• Ramana Adapa, MD

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Tracy, CA
  • NPI 1407959315
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360713600000",
    "number": "1659540870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 W 11TH ST",
            "address_2": "SUITE 137",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763869",
            "telephone_number": "209-833-7555",
            "fax_number": "209-833-7518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 W 11TH ST",
            "address_2": "SUITE 137",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763869",
            "telephone_number": "209-833-7555",
            "fax_number": "209-833-7518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAUTAMI AGASTYA, MD., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2013-02-13",
        "status": "A",
        "authorized_official_last_name": "AGASTYA",
        "authorized_official_first_name": "GAUTAMI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-833-7555",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C51385",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CA",
            "license": "A85126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garfield Beach CVS LLC (CVS Pharmacy #16223)
• Rachael Garner
• Dominic J Garrett
• Johannes F Garrido, D.C.
• Eva Gasior, DDS
• Emilyanne Gayares
• Tracy Ann Gayeski, PSY.D.
• Izabel Gaytan
• Tyler Anthony Geipel
• George Shiao, DMD

• Preventive Medicine/Occupational Environmental Medicine Physician in Tracy, CA
• Providers in Tracy, CA by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.