Individual provider Active NPI

Gayle Katherine Kouklis, MD

  • Emergency Medicine Physician
  • Fresno, CA
National Provider Identifier
1720540610
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD61538456 Issued in WA
Practice address
2823 Fresno St
Fresno, CA 93721-1324
Phone
(559) 443-2682
Fax
(559) 443-2681
NPI assigned
Apr 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A181137 CA
Emergency Medicine Physician 207P00000X MD61538456 WA Primary

Addresses

Primary practice location

2823 Fresno St
Fresno, CA 93721-1324

Mailing address

2625 E Divisadero St
Fresno, CA 93721-1431
Phone (559) 443-2682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230214001973 CA Practitioner - Emergency Medicine 7517339864 Reassigns benefits to 3 organizations
I20241105001637 WA Practitioner - Emergency Medicine 7517339864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Cincinnati College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

21601 76TH Ave W
Edmonds, WA 98026-7507
Phone (425) 640-4100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as group
Quality
76.71
Promoting interoperability
100
Improvement activities
40
Cost
74

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A181137CAMDEmergency Medicine Physician
MD61538456WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Faculty Associates, Inc. Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Central California Faculty Medical Group, Inc. Emergency Medicine CurrentSince Dec 1, 2024 Accepting new patients
University Faculty Associates, Inc. CurrentSince Aug 1, 2023 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Dec 15, 2025 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Nov 1, 2024 Accepting new patients
San Joaquin Emergency Medical Associates Emergency Medicine CurrentSince Oct 22, 2022 Accepting new patients
Central California Faculty Medical Group, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Dec 15, 2025 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Nov 1, 2024 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

2335 E Kashian Ln
Ste 240
Fresno, CA 93701
Phone (559) 320-0545

2625 E Divisadero St
Fresno, CA 93721
Phone (559) 453-5200

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

155 N Fresno St
Fresno, CA 93701
Phone (559) 499-6440

726 4th St
Marysville, CA 95901
Phone (530) 491-9491

333 Mercy Ave
Merced, CA 95340
Phone (209) 385-1280

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

21601 76th Ave W
Edmonds, WA 98026
Phone (425) 640-4000

Interoperability endpoints

  • Direct secure messaging: gkouklis613817@hisp.ehr.sutterhealth.org
  • Direct secure messaging: gkouklis799655@direct.peacehealth.org

Organizations & group practices 10

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 4

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": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1720540610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 E DIVISADERO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211431",
            "telephone_number": "559-443-2682",
            "fax_number": "559-443-2681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211324",
            "telephone_number": "559-443-2682",
            "fax_number": "559-443-2681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUKLIS",
        "first_name": "GAYLE",
        "middle_name": "KATHERINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A181137",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD61538456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.