NPIMap

Individual provider Active NPI

Gina M. Carbonaro, PA-C

  • Surgical Physician Assistant
  • Silver Spring, MD
National Provider Identifier
1003972027
Registry record updated Dec 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
C0002102 Issued in MD
Practice address
831 University Blvd E Ste 36a
Silver Spring, MD 20903-2915
Phone
(301) 408-2720
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X C0002102 MD Primary

Addresses

Primary practice location

831 University Blvd E Ste 36a
Silver Spring, MD 20903-2915

Mailing address

831 University Blvd E Ste 36a
Silver Spring, MD 20903-2915
Phone (301) 408-2720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Health Service Inc. PastSince Dec 9, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1003972027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 UNIVERSITY BLVD E STE 36A",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209032915",
            "telephone_number": "301-408-2720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 UNIVERSITY BLVD E STE 36A",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209032915",
            "telephone_number": "301-408-2720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBONARO",
        "first_name": "GINA",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C0002102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.