Individual provider Active NPI

Kathleen Mantz Gotwals, PA-C

  • Medical Physician Assistant
  • Pennsburg, PA
National Provider Identifier
1033119482
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA002439L Issued in PA
Practice address
2781 Geryville Pike
Pennsburg, PA 18073-2306
Phone
(215) 679-8071
Fax
(215) 541-4171
NPI assigned
Jul 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA002439L PA Primary

Addresses

Primary practice location

2781 Geryville Pike
Pennsburg, PA 18073-2306

Mailing address

PO Box 216
Pennsburg, PA 18073-0216
Phone (215) 679-8071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150129000581 PA Practitioner - Physician Assistant 9638493307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Quakertown Family Medical CenterGroup PAC ID 0244250843, 3 clinicians

Practice addresses (Care Compare)

1548 W Broad St
Quakertown, PA 18951-1001

920 Lawn Ave
Suite 4
Sellersville, PA 18960-1560
Phone (267) 347-4747

Hospital & facility affiliations

  • St Luke'S Hospital - Grand View Campus Hospital, Sellersville, PA, CCN 390057
  • St Luke'S Hospital - Upper Bucks Campus Hospital, Quakertown, PA, CCN 390035
  • Doylestown Hospital Hospital, Doylestown, PA, CCN 390203

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA002439LPAMDMedical Physician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033119482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 216",
            "city": "PENNSBURG",
            "state": "PA",
            "postal_code": "180730216",
            "telephone_number": "215-679-8071",
            "fax_number": "215-541-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2781 GERYVILLE PIKE",
            "city": "PENNSBURG",
            "state": "PA",
            "postal_code": "180732306",
            "telephone_number": "215-679-8071",
            "fax_number": "215-541-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTWALS",
        "first_name": "KATHLEEN",
        "middle_name": "MANTZ",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA002439L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pennsburg, PA

Sources for this page

Verify at the official NPI Registry.