Zachary Noah Gastelum, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

04-44693 Issued in KS

Practice address

625 Kentucky St
Ashland, KS 67831-3199

Phone

(620) 635-2241

NPI assigned

Apr 17, 2018

Last updated

Oct 25, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1730676529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 KENTUCKY ST",
            "city": "ASHLAND",
            "state": "KS",
            "postal_code": "678313199",
            "telephone_number": "620-635-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 KENTUCKY ST",
            "city": "ASHLAND",
            "state": "KS",
            "postal_code": "678313199",
            "telephone_number": "620-635-2241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASTELUM",
        "first_name": "ZACHARY",
        "middle_name": "NOAH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-17",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "TL.0007184",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-44693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• County of Clark
• County of Clark (Clark County Ambulance)
• D & B Pharmacy
• Rhodena Dewitt, RDN-LD
• Kimberly J Farris, PA-C
• Kelby Rae Green, DPT
• Linda Jensen
• Leslie Kvinge, DPT
• Dustin Cole McPhail, D.C
• James W Moffitt, MD

• Family Medicine Physician in Ashland, KS
• Providers in Ashland, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.