Individual provider Active NPI

Gregory R Gambla, DO

  • Gastroenterology Physician
  • Elgin, IL
National Provider Identifier
1801832167
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036098608 Issued in IL
Practice address
745 Fletcher Dr
Ste 202
Elgin, IL 60123-4747
Phone
(847) 888-1300
Fax
(847) 888-1341
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036098608 IL Primary

Addresses

Primary practice location

745 Fletcher Dr
Ste 202
Elgin, IL 60123-4747

Mailing address

39W357 Baker Dr
Geneva, IL 60134-6114
Phone (630) 208-9848

Other identifiers 1

IdentifierTypeStateIssuer
036098608MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20061213000357 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 4385643717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Midwestern University, Chicago College of Osteopathic Med, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Gastroenterology Group LLCGroup PAC ID 5193857423, 116 clinicians

Practice addresses (Care Compare)

745 Fletcher Dr
Suite 202
Elgin, IL 60123-4749
Phone (847) 888-1300

Hospital & facility affiliations

  • Advocate Sherman Hospital Hospital, Elgin, IL, CCN 140030
  • Saint Joseph Hospital-Elgin Hospital, Elgin, IL, CCN 140217
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116

Merit-based Incentive Payment System (MIPS)

Final score
84.21 of 100Reported as group
Quality
67.65
Promoting interoperability
99
Improvement activities
40
Cost
80.55

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy143
Upper gastrointestinal (GI) endoscopy for acid reflux115

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036098608ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elgin Gastroenterology SC Gastroenterology Current Accepting new patients
Elgin Gastroenterology Endoscopy Center LLC Current Accepting new patients
Illinois Gastroenterology Group, LLC Gastroenterology CurrentSince Jun 1, 2010 Accepting new patients
Northwest Gastroenterologists SC Current Accepting new patients
Urvish K Shah, MD PC Gastroenterology Past Accepting new patients

Locations

4900 S State Route 31
Ste 111
Crystal Lake, IL 60012
Phone (847) 289-9146

1425 N McLean Blvd
Ste 600
Elgin, IL 60123

745 Fletcher Dr
Ste 202
Elgin, IL 60123
Phone (855) 483-7362

912 Northwest Hwy
Ste 104
Fox River Grv, IL 60021
Phone (847) 516-4400

1555 N Barrington Rd
Ste 400
Hoffman Estates, IL 60169
Phone (847) 519-1600

165 N Lakewood Rd
Ste D
Lake in the Hills, IL 60156

2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246

2000 McDonald Rd
Ste 260
South Elgin, IL 60177

Organizations & group practices 5

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 6

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1801832167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39W357 BAKER DR",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601346114",
            "telephone_number": "630-208-9848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 FLETCHER DR",
            "address_2": "STE 202",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234747",
            "telephone_number": "847-888-1300",
            "fax_number": "847-888-1341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLA",
        "first_name": "GREGORY",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036098608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098608",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.