Individual provider Active NPI

Kiranpal Gill, PA-C

  • Physician Assistant
  • Cypress, TX
National Provider Identifier
1053599852
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA09065 Issued in TX
Practice address
26265 Northwest Fwy
Cypress, TX 77429-1760
Phone
(330) 607-0440
Fax
(401) 652-9787
NPI assigned
Feb 4, 2008
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 PA09065 TX Primary

Addresses

Primary practice location

26265 Northwest Fwy
Cypress, TX 77429-1760

Mailing address

26265 Northwest Fwy
Cypress, TX 77429-1760
Phone (330) 607-0440

Other practice location 1

9104 Babcock Blvd
Suite #3111
Pittsburgh, PA 15237-5818
Phone (412) 366-2950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231102000389 MO Practitioner - Physician Assistant 6800973884 Reassigns benefits to 1 organization
I20240923000471 IL Practitioner - Physician Assistant 6800973884 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Pain Management Services LLC CurrentSince Sep 30, 2023 Accepting new patients

Locations

247 Dunn Rd
Florissant, MO 63031
Phone (314) 438-0700

261 Dunn Rd
Florissant, MO 63031
Phone (314) 270-9446

Interoperability endpoints

  • Direct secure messaging: kiranpal.gill@768220391342084.direct.elationemr.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1053599852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26265 NORTHWEST FWY",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774291760",
            "telephone_number": "330-607-0440",
            "fax_number": "401-652-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26265 NORTHWEST FWY",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774291760",
            "telephone_number": "330-607-0440",
            "fax_number": "401-652-9787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9104 Babcock Blvd",
            "address_2": "Suite #3111",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152375818",
            "country_code": "US",
            "telephone_number": "412-366-2950",
            "fax_number": "412-366-2775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILL",
        "first_name": "KIRANPAL",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-04",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

Verify at the official NPI Registry.