Individual provider Active NPI

Kyle Benjamin Gambrel, PA-C

  • Physician Assistant
  • Mansfield, OH
National Provider Identifier
1043726359
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.007238RX Issued in OH
Practice address
335 Glessner Ave
Mansfield, OH 44903-2269
Phone
(740) 383-8473
Fax
(740) 383-8695
NPI assigned
Dec 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.007238RX OH Primary

Addresses

Primary practice location

335 Glessner Ave
Mansfield, OH 44903-2269

Mailing address

PO Box 7527
Dublin, OH 43017-0727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20211216002351 OH Practitioner - Physician Assistant 8921369901 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intensive Care Experts Health Network, LLCGroup PAC ID 6608195599, 99 clinicians
Mount Carmel Healthproviders Two LLCGroup PAC ID 6608828447, 222 clinicians

Practice addresses (Care Compare)

433 Obetz Rd
Columbus, OH 43207-4098
Phone (614) 491-2000

6001 E Broad St
Mount Carmel Palliative Care
Columbus, OH 43213-1502
Phone (614) 234-6000

Hospital & facility affiliations

  • Mount Carmel East & West Hospital, Columbus, OH, CCN 360035
  • Mount Carmel St Ann'S Hospital, Westerville, OH, CCN 360012

Merit-based Incentive Payment System (MIPS)

Final score
79.44 of 100Reported as group
Quality
75.57
Promoting interoperability
79
Improvement activities
40
Cost
73.41

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.007238RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Jan 1, 2021 Accepting new patients
Mount Carmel Healthproviders Two LLC CurrentSince Jan 30, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

6150 E Broad St
Columbus, OH 43213
Phone (614) 546-4400

335 Glessner Ave
Mansfield, OH 44903
Phone (419) 522-0320

Organizations & group practices 6

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": "1513814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1043726359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 GLESSNER AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032269",
            "telephone_number": "740-383-8473",
            "fax_number": "740-383-8695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBREL",
        "first_name": "KYLE",
        "middle_name": "BENJAMIN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-21",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.007238RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

Verify at the official NPI Registry.