Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

RUPALI GAUTAM DO
NPI 1912602327
Student in an Organized Health Care Education/Training Program in San Diego, CA

Q: What is Rupali Gautam's NPI number?

The NPI number for Rupali Gautam is 1912602327. It was assigned to this individual provider in the NPPES registry on April 4, 2023.

Q: What is Rupali Gautam's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Rupali Gautam was last updated on June 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 57 days 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 April 04, 2023PECOS Enrolled

3665 KEARNY VILLA RD STE 500, SAN DIEGO, CA 92123(858) 966-4011 Get Directions Write a Review

NPPES record last updated: June 26, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Rupali Gautam Do NPPES

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

RUPALI GAUTAM DO (NPI 1912602327) is an individual student in an organized health care education/training program in San Diego, California and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912602327

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameRUPALI GAUTAMCredential: DO

Location Address3665 KEARNY VILLA RD STE 500San Diego, CA 92123-2899

Mailing Address3665 Kearny Villa Rd Ste 500San Diego, CA 92123-2899 · (858) 966-4011 · Fax (505) 272-6845

Phone(858) 966-4011

Sole ProprietorNo

Enumeration DateApril 4, 2023

Last NPPES UpdateJune 26, 2026

NPPES CertifiedJune 26, 2026

✔ NPI 1912602327 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

3665 KEARNY VILLA RD STE 500, San Diego, CA 92123

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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 (PECOS)

Rupali Gautam Do 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.

Other Providers at the Same Location NPPES 8

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

HEATHER LODAHL ACSW

Social Worker (Clinical)