NPIMap

Individual provider Active NPI

Gautam S Nayak, M.D.

  • Cardiovascular Disease Physician
  • Wenatchee, WA
National Provider Identifier
1811055254
Registry record updated Jul 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD60072204 Issued in WA
Practice address
1201 S Miller St Ste a
Wenatchee, WA 98801-3201
Phone
(509) 663-8711
NPI assigned
Dec 5, 2006
Last updated
Jul 14, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 2001001483 MO
Cardiovascular Disease Physician 207RC0000X MD60072204 WA Primary

Addresses

Primary practice location

1201 S Miller St Ste a
Wenatchee, WA 98801-3201

Mailing address

820 N Chelan Ave
Wenatchee, WA 98801-2028
Phone (509) 663-8711

Other identifiers 3

IdentifierTypeStateIssuer
1811055254MedicaidWA
P01256423OtherWARR MEDICARE WVH
315514OtherWAWVH LNI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091116000599 WA Practitioner - Cardiovascular Disease (Cardiology) 2264570050 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Tulane University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

700 E Manitoba Ave
Suite 109
Ellensburg, WA 98926-3885
Phone (809) 925-8445

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2001001483MOMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chelan County Public Hospital District No 2 CurrentSince Feb 1, 2026 Accepting new patients
Kittitas County Public Hospital Dist 1 CurrentSince Oct 11, 2024 Accepting new patients
Kittitas County Public Hospital Dist 1 Current Accepting new patients
Kittitas County Public Hosp Dist 1 CurrentSince Oct 11, 2024 Accepting new patients
Chelan County Public Hospital District No 2 CurrentSince Feb 1, 2026 Accepting new patients
Wenatchee Valley Hospital CurrentSince Jul 21, 2013 Accepting new patients
Chelan County Public Hospital Dist No 2 CurrentSince Feb 1, 2026 Accepting new patients
Lake Chelan Clinic, P.C. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Kittitas County Public Hospital Dist 1 Past Accepting new patients

Locations

110 S Apple Blossom Dr
Chelan, WA 98816
Phone (509) 682-3300

131 S Apple Blossom Dr
Unit 112
Chelan, WA 98816
Phone (218) 791-8759

219 E Johnson Ave
Chelan, WA 98816
Phone (509) 682-2511

201 Alpha Way
Cle Elum, WA 98922
Phone (509) 674-5331

603 S Chestnut St
Ellensburg, WA 98926
Phone (509) 933-8693

700 E Manitoba Ave
Ellensburg, WA 98926
Phone (509) 925-6100

700 E Manitoba Ave
Ste 109
Ellensburg, WA 98926
Phone (509) 925-6947

717 Okoma Dr
Omak, WA 98841
Phone (509) 826-1191

17 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2174

1201 S Miller St
Wenatchee, WA 98801
Phone (509) 662-2208

1201 S Miller St
Ste A
Wenatchee, WA 98801
Phone (509) 667-2003

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868

933 Red Apple Rd
Wenatchee, WA 98801
Phone (509) 655-6125

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1811055254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028",
            "telephone_number": "509-663-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S MILLER ST STE A",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988013201",
            "telephone_number": "509-663-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAYAK",
        "first_name": "GAUTAM",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2001001483",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD60072204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811055254",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE WVH",
            "identifier": "P01256423",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WVH LNI",
            "identifier": "315514",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

Verify at the official NPI Registry.