Carla Collins Gorum, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A86939 Issued in CA

Practice address

1820 41St Ave
Suite D
Capitola, CA 95010-2516

Phone

(831) 476-3000

Fax

(831) 476-9009

NPI assigned

Sep 29, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Pediatric Medicine

Education

Medical College of Pennsylvania, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cgorum30138@hisp.ehr.sutterhealth.org

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.

• Sutter Bay Medical Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment Care Compare group NPD
• Sutter Bay Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• Dignity Health

  • General Acute Care Hospital
  • Santa Cruz, CA
  • NPI 1427181007
  NPD (past)
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Santa Cruz, CA
  • NPI 1689035628
  NPD (past)
• Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
  • NPI 1871538769
  NPD (past)

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351814400000",
    "number": "1679560197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956",
            "telephone_number": "916-379-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 41ST AVE",
            "address_2": "SUITE D",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102516",
            "telephone_number": "831-476-3000",
            "fax_number": "831-476-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORUM",
        "first_name": "CARLA",
        "middle_name": "COLLINS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2012-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A86939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Golden Age Convalescent Hospital, Inc
• Golden State Orthopedics & Spine
• Golden State Orthopedics & Spine
• Natalie Gonzalez
• Persephone B. Gonzalez
• Patrick Michael Grant, DPT
• Lana Grassi
• Stephanie Melton Graziani, DO
• Nancy L Greenstreet, M.D.
• Julia H Greenwood, NP

• Pediatrics Physician in Capitola, CA
• Providers in Capitola, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; 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.