DR. DONALD DOUGLAS GANDY (DO) – Emergency Medicine Physician, NPI 1073552808
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
560 INTERNAL MEDICINE in ID
Provider Addresses for DR. DONALD DOUGLAS GANDY (DO)
229 S 7th St Ste 101
St Maries, ID 838611803
Phone: (208) 245-7079
Fax: (208) 245-5246
Type: Location
229 S 7th St
St Maries, ID 838611803
Phone: (208) 245-5551
Fax: (208) 245-2262
Type: Location
229 S 7TH ST
ST MARIES, ID 838611803
Phone: (208) 245-5551
Fax: (208) 245-2262
Type: Mailing
229 S 7TH ST STE 300
ST MARIES, ID 838611803
Phone: (208) 245-2591
Fax: (208) 245-5246
Type: Location
Shasta Regional Medical Center, 1100, Butte Street, Redding, Shasta County, California, 96001, United States
REDDING, CA 960010852
Phone: (530) 243-0498
Fax: (530) 243-1309
Type: Location
498, River Park Drive, The Vistas, Redding, Shasta County, California, 96003, United States
REDDING, CA 960035367
Phone: (530) 242-6602
Fax: (530) 243-1309
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-07-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100924001201 | I | Emergency Medicine | NV | TBD |
| I20240705002103 | I | Internal Medicine | ID | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 83861)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | ID | |
| - | ID | |
| Emergency Medicine | ID | |
| Certified Registered Nurse Anesthetist (Crna) | ID | |
| - | ID | |
| Diagnostic Radiology, Interventional Radiology, Interventional Radiology, Diagnostic Radiology | MN | |
| Diagnostic Radiology | ID | |
| Diagnostic Radiology | ID | |
| - | ID | |
| Emergency Medicine | ID |
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