Individual provider Active NPI

Gerald R. Gaul, M.D.

  • Ophthalmology Physician
  • Grand Forks, ND
National Provider Identifier
1801893490
Registry record updated Jun 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
5783 Issued in ND
Practice address
3035 Demers Ave
Grand Forks, ND 58201-4018
Phone
(701) 775-3151
Fax
(701) 775-3153
NPI assigned
Jun 28, 2005
Last updated
Jun 23, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 5783 ND
Ophthalmology Physician 207W00000X 5783 ND Primary

Addresses

Primary practice location

3035 Demers Ave
Grand Forks, ND 58201-4018

Mailing address

3035 Demers Ave
Grand Forks, ND 58201-4018
Phone (701) 775-3151

Other identifiers 1

IdentifierTypeStateIssuer
16160MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, GA2 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
I20081031000510 MN Practitioner - Ophthalmology 2062446511 Reassigns benefits to 1 organization
I20260527000181 GA Practitioner - Ophthalmology 2062446511

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Mayo Medical School, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13375 Avensong Xing
Alpharetta, GA 30004-7444

13616 California St
Suite 300
Omaha, NE 68154-5335

4120 N Valdosta Rd
Suite a
Valdosta, GA 31602-4973

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5783NDMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Eye Center PLLC CurrentSince Mar 26, 2008 Accepting new patients
North Dakota Eye Clinic, LTD Ophthalmology PastSince Jun 10, 1992 Accepting new patients

Locations

901 Hanson Dr
Thief Rvr Fls, MN 56701
Phone (218) 681-1777

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1801893490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014018",
            "telephone_number": "701-775-3151",
            "fax_number": "701-775-3153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014018",
            "telephone_number": "701-775-3151",
            "fax_number": "701-775-3153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUL",
        "first_name": "GERALD",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ND",
            "license": "5783",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ND",
            "license": "5783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16160",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.