DR. GARY GADDIS (MD) – Emergency Medicine Physician, NPI 1417060310

DR. GARY GADDIS (MD) is a healthcare provider. based in Saint louis, Missouri. specializing in EMERGENCY MEDICINE, GENERAL PRACTICE. They hold the professional credentials MD. They hold a License No. R5J76 (MO). The NPI Number for DR. GARY GADDIS (MD) is 1417060310

Main info

Male
40 Years Of Experience
Accepts Medicare Assignment
Name
DR. GARY GADDIS (MD)
NPI
1417060310
Phone
(314) 362-9123
Address
660 S EUCLID AVE
Enumeration Date
16 August 2006
Last Update Date
24 January 2018

Doctor Profile

Medical School Name
INDIANA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6606461480
Graduation Year
1986 (40 years ago)
PAC ID
0446150114
Group Practice PAC ID
0143130393
Professional Enrollment ID
I20100311000208
Address ID
MO646012902CH2799XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,351 EMERGENCY MEDICINE in MO

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Provider Addresses for DR. GARY GADDIS (MD)

  • Bernard Becker Medical Library, 660, South Euclid Avenue, Central West End, St. Louis, Missouri, 63110, United States

    C B 8072

    SAINT LOUIS, MO 631101010

    Phone: (314) 362-9123

    Fax: (314) 747-3338

    Type: Mailing

  • South Kingshighway Boulevard, North Hampton, City of Saint Louis, Missouri, 63116, United States

    SAINT LOUIS, MO 631101014

    Phone: (314) 362-9123

    Fax: (314) 747-3338

    Type: Location

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: 2010-03-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100311000208IEmergency MedicineMOTBD

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.

Verify on CMS Revalidation Lookup Tool

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 63110)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0143130393View full group profile

Reviews

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Frequently asked questions

Is DR. GARY GADDIS (MD) listed with a National Provider Identifier?
Yes — DR. GARY GADDIS (MD) has NPI 1417060310 on file in the registry.
Active or inactive — what applies to DR. GARY GADDIS (MD)?
You should see DR. GARY GADDIS (MD) as active in CMS-hosted NPPES data.
What area of care is associated with DR. GARY GADDIS (MD)?
DR. GARY GADDIS (MD)'s record emphasizes Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. GARY GADDIS (MD)?
Travel planning: use Saint Louis, Missouri as the reference point for DR. GARY GADDIS (MD), then confirm.
Can I trust this NPI listing for DR. GARY GADDIS (MD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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