OZONE GAUTAM MD
NPI 1053042366
Internal Medicine in Vancouver, WA

Q: What is Ozone Gautam's NPI number?

The NPI number for Ozone Gautam is 1053042366. It was assigned to this individual provider in the NPPES registry on June 19, 2022.

Q: What is Ozone Gautam's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Ozone Gautam was last updated on July 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 19, 2022PECOS EnrolledAccepts Medicare Assignment

2211 NE 139TH ST, VANCOUVER, WA 98686(360) 487-1168(503) 413-7361 Get Directions Write a Review

NPPES record last updated: July 15, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Ozone Gautam Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OZONE GAUTAM MD (NPI 1053042366) is an individual internal medicine provider in Vancouver, Washington, licensed in Virginia (0101285256) and active in the NPI registry since June 2022. He is enrolled in Medicare PECOS, is affiliated with Sovah Health Danville, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1053042366

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameOZONE GAUTAMCredential: MD

Location Address2211 NE 139TH STVancouver, WA 98686-2742

Mailing Address2211 Ne 139th StVancouver, WA 98686-2742 · (360) 487-1168

Phone(360) 487-1168

Fax(503) 413-7361

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateJune 19, 2022

Last NPPES UpdateJuly 15, 2025

NPPES CertifiedJuly 15, 2025

✔ NPI 1053042366 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in VA · 0101285256

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License MDRE.ML.61299254 (WA)

2211 NE 139TH ST, Vancouver, WA 98686

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ozone Gautam Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8628458965

PECOS Enrollment IDI20250728000168

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Sovah Health Danville

Acute Care Hospitals · Danville, VA

2/5 CMS rating

OwnershipProprietary

CMS Certification Number490075

Location142 South Main StreetDanville, VA 24541 · Danville City County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98686 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$130.99 typical visit price

range $57.27 – $172.80

Typical copayment $32.74 (range $14.31 – $43.20)

Most-billed visit code 99204

Established Patient

$100.78 typical visit price

range $18.56 – $141.11

Typical copayment $25.19 (range $4.64 – $35.27)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NATALIA SAYURI MUTO MD

Student in an Organized Health Care Education/Training Program