KELLY MEAD GAUGHEN D.O.
NPI 1184988008
Pediatrics in Castro Valley, CA

Q: What is Kelly Gaughen's NPI number?

The NPI number for Kelly Gaughen is 1184988008. It was assigned to this individual provider in the NPPES registry on June 25, 2012.

Q: What is Kelly Gaughen's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Gaughen was last updated on October 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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 25, 2012PECOS Enrolled

20101 LAKE CHABOT RD FL 3, CASTRO VALLEY, CA 94546(510) 886-3400 Get Directions Write a Review

NPPES record last updated: October 3, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 3, 2024, Jul 21, 2022, Mar 17, 2018 and 1 more (4 updates tracked since 2017).

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About Kelly Mead Gaughen D.o. NPPES

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

KELLY MEAD GAUGHEN D.O. (NPI 1184988008) is an individual pediatrics provider in Castro Valley, California, licensed in California (20A22401) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1184988008

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameKELLY MEAD GAUGHENCredential: D.O.

Location Address20101 LAKE CHABOT RD FL 3Castro Valley, CA 94546-5305

Mailing Address325 Distel CirLos Altos, CA 94022-1408 · (510) 886-3400

Phone(510) 886-3400

Sole ProprietorNo

Enumeration DateJune 25, 2012

Last NPPES UpdateOctober 3, 20244 updates tracked since enumeration

NPPES CertifiedOctober 3, 2024

✔ NPI 1184988008 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Licenses✔ Licensed in CA · 20A22401✔ Licensed in IL · 036.137326✔ Licensed in OH · 34.012728

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License AC3890313-T050 (IL)

20101 LAKE CHABOT RD FL 3, Castro Valley, CA 94546

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Secondary Practice Locations 2

Location 14440 W 95th StOak Lawn, IL 60453-2600 · Phone (708) 684-3296

Location 2919 2nd St NECanton, OH 44704-1132 · Phone (330) 453-3386

Other Identifiers 1

Medicaid270950OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Mead Gaughen D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Kelly Gaughen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sutter Bay Medical Foundation

13 mi

Multi-Specialty

12 CAMINO ENCINAS
Orinda, CA 94563

Reassigned Medicare billing, California enrollment
4,479 clinicians in this Medicare group

NPI 1366898538 (510) 204-8180

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94546 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

$104.51 typical visit price

range $69.00 – $202.35

Typical copayment $26.12 (range $17.25 – $50.58)

Most-billed visit code 99203

Established Patient

$119.48 typical visit price

range $23.44 – $166.46

Typical copayment $29.87 (range $5.86 – $41.61)

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 12

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

AHLAM MAHMOOD ALGAZZALI PHYSICIAN ASSISTANT

Physician Assistant