Individual provider Active NPI

Justin Scott Gatewood, MD

  • Emergency Medicine Physician
  • Conshohocken, PA
National Provider Identifier
1811199987
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD036600 Issued in DC
Practice address
1000 River Rd
Ste 100
Conshohocken, PA 19428-2439
Phone
(800) 355-3818
Fax
(610) 834-2862
NPI assigned
Jun 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD036600 DC Primary

Addresses

Primary practice location

1000 River Rd
Ste 100
Conshohocken, PA 19428-2439

Mailing address

110 Irving St NW
Washington, DC 20010-2976
Phone (202) 877-7632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20140115000416 CA Practitioner - Emergency Medicine 5193819407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Washington School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mills-Peninsula Emergency Medical Associates, IncGroup PAC ID 4183668908, 28 clinicians

Practice addresses (Care Compare)

1501 Trousdale Dr
Burlingame, CA 94010-4506
Phone (650) 696-5500

Hospital & facility affiliations

  • Peninsula Medical Center Hospital, Burlingame, CA, CCN 050007

Merit-based Incentive Payment System (MIPS)

Final score
94.03 of 100Reported as group
Quality
95
Improvement activities
40
Cost
80.65

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mills Peninsula Emergency Medical Associates Inc Emergency Medicine CurrentSince Sep 1, 2013 Accepting new patients
Mills Peninsula Emergency Medical Associates Inc Emergency Medicine CurrentSince Sep 1, 2013 Accepting new patients
Sutter East Bay Medical Foundation Emergency Medicine Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Sutter Bay Medical Foundation Past Accepting new patients

Locations

1501 Trousdale Dr
Burlingame, CA 94010
Phone (650) 696-3520

Interoperability endpoints

  • Direct secure messaging: jgatewood189306@hisp.ehr.sutterhealth.org

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 2

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": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1811199987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 IRVING ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102976",
            "telephone_number": "202-877-7632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 RIVER RD",
            "address_2": "STE 100",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282439",
            "telephone_number": "800-355-3818",
            "fax_number": "610-834-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATEWOOD",
        "first_name": "JUSTIN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "DC",
            "license": "MD036600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conshohocken, PA

Sources for this page

Verify at the official NPI Registry.