Individual provider Active NPI

James Edward Gaydos, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Walnut Creek, CA
National Provider Identifier
1790778439
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
20A11811 Issued in CA
Practice address
2900 Camino Diablo
Suite 200
Walnut Creek, CA 94597-3999
Phone
(925) 464-2100
Fax
(925) 464-2110
NPI assigned
Aug 29, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A11811 CA
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 20A11811 CA Primary

Addresses

Primary practice location

2900 Camino Diablo
Suite 200
Walnut Creek, CA 94597-3999

Mailing address

PO Box 1878
Martinez, CA 94553-0878
Phone (925) 464-2100

Other identifiers 1

IdentifierTypeStateIssuer
OVN2048MedicaidVT

Medicare participation

Medicare enrollment files
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.
Opted out of Medicare
Previously, effective Aug 21, 2014 through Aug 21, 2026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A11811CAMDFamily Medicine Physician
11811CAMDSpeech-Language Pathologist

Interoperability endpoints

  • Direct secure messaging: jegaydos@jegd-ca.direct.office.nextgen.com

NPI Registry JSON

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1790778439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1878",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945530878",
            "telephone_number": "925-464-2100",
            "fax_number": "925-464-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 CAMINO DIABLO",
            "address_2": "SUITE 200",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945973999",
            "telephone_number": "925-464-2100",
            "fax_number": "925-464-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYDOS",
        "first_name": "JAMES",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A11811",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "CA",
            "license": "20A11811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN2048",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.