NICOLE GUMPORT PHD
NPI 1679337810
Psychologist in Stanford, CA

Active since February 08, 2024PECOS EnrolledAccepts Medicare Assignment
300 PASTEUR DR, STANFORD, CA 94305(650) 723-4000 Get Directions Write a Review

NPPES record last updated: July 11, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 11, 2024, Feb 8, 2024 (2 updates tracked since 2024).

About Nicole Gumport Phd NPPES

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

NICOLE GUMPORT PHD (NPI 1679337810) is an individual psychologist in Stanford, California, licensed in California (PSY34246) and active in the NPI registry since February 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1679337810
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameNICOLE GUMPORTCredential: PHD
Location Address300 PASTEUR DRStanford, CA 94305-2200
Mailing Address300 Pasteur DrStanford, CA 94305-2200 · (650) 723-4000
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateFebruary 8, 2024
Last NPPES UpdateJuly 11, 20242 updates tracked since enumeration
NPPES CertifiedJuly 11, 2024
✔ NPI 1679337810 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in CA · PSY34246
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
300 PASTEUR DR, Stanford, CA 94305

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicole Gumport Phd 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 ID1153762018
PECOS Enrollment IDI20240516001193
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 Reassignments

2

Medicare enrollment records show Nicole Gumport reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

General Acute Care Hospital
300 PASTEUR DRIVE
Stanford, CA 94305
  • Reassigned Medicare billing, California enrollment
  • 4,258 clinicians in this Medicare group
Children
725 WELCH RD
Palo Alto, CA 94304
  • Reassigned Medicare billing, California enrollment
  • 3,617 clinicians in this Medicare group

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

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.

Internal Medicine (Gastroenterology)
300 PASTEUR DR, ALWAY BUILD M211, MC 5187
STANFORD, CA 94305
Radiology (Vascular & Interventional Radiology)
300 PASTEUR DR
STANFORD, CA 94305
Psychiatry & Neurology (Psychiatry)
300 PASTEUR DR
STANFORD, CA 94305
Radiology (Diagnostic Radiology)
300 PASTEUR DR
STANFORD, CA 94305
Nurse Practitioner
300 PASTEUR DR
STANFORD, CA 94305
Neurological Surgery
300 PASTEUR DR
STANFORD, CA 94305
Pathology (Anatomic Pathology & Clinical Pathology)
300 PASTEUR DR, LANE 235
STANFORD, CA 94305
Internal Medicine (Critical Care Medicine)
300 PASTEUR DR
STANFORD, CA 94305

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Gumport's NPI number?

The NPI number for Nicole Gumport is 1679337810. It was assigned to this individual provider in the NPPES registry on February 8, 2024.

Where is Nicole Gumport located?

Nicole Gumport practices at 300 Pasteur Dr, Stanford, CA 94305. The listed phone number is (650) 723-4000.

What is Nicole Gumport's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Nicole Gumport enrolled in Medicare?

Yes. Nicole Gumport is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Nicole Gumport's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Gumport reassigns Medicare benefits to 2 organizations: Stanford Health Care (Stanford, CA) and Lpch Medical Group Div Of Lucile (Palo Alto, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicole Gumport's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nicole Gumport was last updated on July 11, 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.