Ivan Dedrick Gavin Hamilton, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A104632 Issued in CA

Practice address

2351 Clay St
Suite 308
San Francisco, CA 94115-1931

Phone

(415) 600-3458

Fax

(415) 600-3451

NPI assigned

May 10, 2006

Last updated

May 28, 2021By the provider in NPPES

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

Internal Medicine

Education

Georgetown University School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

La Clinica de la Raza IncGroup PAC ID 1557258282, 130 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Silverline Staff Home Health Home health agency, Fremont, CA, CCN 559548
• Athome Healthcare Team, LLC Home health agency, American Canyon, CA, CCN 059644
• Sutter Solano Medical Center Hospital, Vallejo, CA, CCN 050101

Merit-based Incentive Payment System (MIPS)

Final score

82.4 of 100Reported as group

Quality

65.6

Improvement activities

40

Cost

71.06

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• La Clinica de la Raza Inc

  dba La Clinica Monument

  • Federally Qualified Health Center (FQHC)
  • Concord, CA
  • NPI 1538181482
  Medicare reassignment Care Compare group
• Galen Inpatient Physicians, PC

  • Hospitalist Physician
  • Manteca, CA
  • NPI 1689320459
  Medicare reassignment NPD
• Hospitalists of Modesto Medical Group Inc

  • Internal Medicine Physician
  • Modesto, CA
  • NPI 1821190711
  Medicare reassignment NPD
• Galen Inpatient Physicians PC

  • Hospitalist Physician
  • Los Angeles, CA
  • NPI 1205787686
  NPD
• Galen Inpatient Physicians PC

  dba Vituity

  • Internal Medicine Physician
  • Redding, CA
  • NPI 1528312758
  NPD
• La Clinica de la Raza Inc

  dba La Clinica de La Raza

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1144336181
  NPD
• La Clinica de la Raza Inc

  dba La Clinica Dental at Children's Hospital Oakland

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1346262292
  NPD
• La Clinica de la Raza Inc

  dba La Clinica Vallejo

  • Federally Qualified Health Center (FQHC)
  • Vallejo, CA
  • NPI 1992811392
  NPD
• Hospitalists of Modesto Medical Group

  • General Acute Care Hospital
  • Modesto, CA
  • NPI 1659712586
  NPD (past)

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

• Athome Healthcare Team, LLC

  • Home Health Agency
  • American Canyon, CA
  • NPI 1285043141
  Care Compare affiliation
• Silverline Staff Inc

  dba Silverline Staff Home Health

  • Home Health Agency
  • Fremont, CA
  • NPI 1902371446
  Care Compare affiliation
• Sutter Valley Hospitals

  dba Sutter Solano Medical Center

  • General Acute Care Hospital
  • Vallejo, CA
  • NPI 1366686248
  Care Compare affiliation

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1669421202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 MCHENRY AVE",
            "address_2": "STE 65B259",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504373",
            "telephone_number": "209-579-5628",
            "fax_number": "209-579-5637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 CLAY ST",
            "address_2": "SUITE 308",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941151931",
            "telephone_number": "415-600-3458",
            "fax_number": "415-600-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "IVAN",
        "middle_name": "DEDRICK GAVIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A104632",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D63437",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669421202",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408417900",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AV608Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Hamilton, MFTI
• Carrie Cathleen Hamilton
• Danielle C Hamilton
• George L. Hamilton, MD
• Holly Kendall Hamilton, PH.D.
• Kevin Hamilton
• Lea Hamilton
• Mark Hamilton
• Monique Marie Hamilton
• Natasha N Hamilton, MA CARE COORDINATOR

• Internal Medicine Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.