Individual provider Active NPI

Kathryn M Smore, MPAS, PA-C

  • Medical Physician Assistant
  • Bryn Mawr, PA
National Provider Identifier
1053611939
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA055027 Issued in PA
Practice address
825 Old Lancaster Rd
Bryn Mawr, PA 19010-3231
Phone
(610) 642-1090
NPI assigned
Oct 26, 2010
Last updated
Jul 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00247000 NJ
Medical Physician Assistant 363AM0700X MA055027 PA Primary

Addresses

Primary practice location

825 Old Lancaster Rd
Bryn Mawr, PA 19010-3231

Mailing address

825 Old Lancaster Rd
Bryn Mawr, PA 19010-3231
Phone (610) 642-1090

Other names 1

  • Kathryn M Gilbert Former name

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
I20140923001042 PA Practitioner - Physician Assistant 2365622677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

825 Old Lancaster Rd
Suite 320
Bryn Mawr, PA 19010-3235
Phone (610) 527-3800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405641600000",
    "number": "1053611939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 OLD LANCASTER RD",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103231",
            "telephone_number": "610-642-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 OLD LANCASTER RD",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103231",
            "telephone_number": "610-642-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMORE",
        "first_name": "KATHRYN",
        "middle_name": "M",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-26",
        "last_updated": "2014-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00247000",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA055027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "GILBERT",
            "middle_name": "M",
            "credential": "MPAS, PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.