Individual provider Active NPI

Richard Leonard Gilliam, M.D.

  • Family Medicine Physician
  • Monterey, CA
National Provider Identifier
1891791265
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G85035 Issued in CA
Practice address
2440 Fremont St Ste 102B
Monterey, CA 93940-6850
Phone
(831) 646-3190
Fax
(831) 646-3195
NPI assigned
Jun 21, 2005
Sex
Male
Sole proprietor
Yes

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
Family Medicine Physician 207Q00000X G85035 CA Primary

Addresses

Primary practice location

2440 Fremont St Ste 102B
Monterey, CA 93940-6850

Mailing address

PO Box 4451
Carmel, CA 93921-4451
Phone (831) 375-6325

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
I20060328000458 CA Practitioner - Family Practice 9638187909 Practice locations: Monterey, CA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Francisco School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2440 N Fremont St
Suite 102B
Monterey, CA 93940-6850
Phone (831) 646-3190

Hospital & facility affiliations

  • Community Hospital of the Monterey Peninsula Hospital, Monterey, CA, CCN 050145

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G85035CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salinas Valley Primecare Medical Group Inc Past Accepting new patients

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.

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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1891791265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4451",
            "city": "CARMEL",
            "state": "CA",
            "postal_code": "939214451",
            "telephone_number": "831-375-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 FREMONT ST STE 102B",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939406850",
            "telephone_number": "831-646-3190",
            "fax_number": "831-646-3195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "RICHARD",
        "middle_name": "LEONARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G85035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

Verify at the official NPI Registry.