Individual provider Active NPI

Gerald Roy Nazareno, MD

  • Emergency Medicine Physician
  • Pleasanton, CA
National Provider Identifier
1679564983
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A53590 Issued in CA
Practice address
5555 W Las Positas Blvd
Pleasanton, CA 94588-4000
Phone
(209) 342-2300
Fax
(209) 524-4240
NPI assigned
Nov 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A53590 CA Primary

Addresses

Primary practice location

5555 W Las Positas Blvd
Pleasanton, CA 94588-4000

Mailing address

4301 Northstar Way
Modesto, CA 95356-9262
Phone (209) 342-2300

Other identifiers 2

IdentifierTypeStateIssuer
00A535900MedicaidCA
00A535900OtherCABLUE SHIELD

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040310000497 CA Practitioner - Emergency Medicine 6709774482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pleasanton Emergency Medical GroupGroup PAC ID 0143118927, 38 clinicians

Practice addresses (Care Compare)

1133 E Stanley Blvd
Livermore, CA 94550-4200
Phone (925) 373-4500

Hospital & facility affiliations

  • Stanford Health Care Tri-Valley Hospital, Pleasanton, CA, CCN 050283

Merit-based Incentive Payment System (MIPS)

Final score
82.7 of 100Reported as group
Quality
57.11
Promoting interoperability
100
Improvement activities
40
Cost
73.85

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pleasanton Emergency Medical Group Emergency Medicine CurrentSince Jan 1, 2004 Accepting new patients

Locations

4000 Dublin Blvd
Dublin, CA 94568
Phone (510) 498-2374

4000 Dublin Blvd
Ste 150
Dublin, CA 94568
Phone (813) 732-7842

1133 E Stanley Blvd
Livermore, CA 94550
Phone (925) 373-4500

1111 E Stanley Blvd
Livermore, CA 94550
Phone (925) 373-4018

5555 W Las Positas Blvd
Pleasanton, CA 94588
Phone (925) 416-3418

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1679564983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 NORTHSTAR WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569262",
            "telephone_number": "209-342-2300",
            "fax_number": "209-524-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 W LAS POSITAS BLVD",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945884000",
            "telephone_number": "209-342-2300",
            "fax_number": "209-524-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZARENO",
        "first_name": "GERALD",
        "middle_name": "ROY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A53590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A535900",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A535900",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.