Individual provider Active NPI

Gary K Hamm, PA-C

  • Physician Assistant
  • Roseville, CA
National Provider Identifier
1861430050
Registry record updated Mar 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17045 Issued in CA
Practice address
3 Medical Plaza Dr
Suite 140
Roseville, CA 95661-3087
Phone
(916) 865-1400
Fax
(916) 865-1401
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA17045 CA Primary

Addresses

Primary practice location

3 Medical Plaza Dr
Suite 140
Roseville, CA 95661-3087

Mailing address

10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (800) 470-0071

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040219000548 CA Practitioner - Physician Assistant 2567357312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2055 Town Ctr PLZ
Suite G130
West Sacramento, CA 95691-5058
Phone (916) 887-7471

250 W Main St
Woodland, CA 95695-3652
Phone (916) 668-6100

2537 Fair Oaks Blvd
Sacramento, CA 95825-7690
Phone (916) 887-4108

2800 L St
Sacramento, CA 95816-5616

2860 Del Paso Rd
Suite 100
Sacramento, CA 95834-9677
Phone (916) 887-7471

4010 Foothills Blvd
Suite 102
Roseville, CA 95747-7241
Phone (800) 972-5547

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA17045CAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: ghamm223801@hisp.ehr.sutterhealth.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490918400000",
    "number": "1861430050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MEDICAL PLAZA DR",
            "address_2": "SUITE 140",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613087",
            "telephone_number": "916-865-1400",
            "fax_number": "916-865-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMM",
        "first_name": "GARY",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2017-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.