Individual provider Active NPI

David Stephen Gawlik, PA-C, MS

  • Surgical Physician Assistant
  • Colchester, VT
National Provider Identifier
1124048822
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0550030787 Issued in VT
Practice address
354 Mountain View Dr
Suite 300
Colchester, VT 05446-5968
Phone
(802) 864-0192
Fax
(802) 860-4919
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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 0550030787 VT Primary

Addresses

Primary practice location

354 Mountain View Dr
Suite 300
Colchester, VT 05446-5968

Mailing address

354 Mountain View Dr
Suite 300
Colchester, VT 05446-5968
Phone (802) 864-0192

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20041025000900 VT Practitioner - Physician Assistant 7214998012 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Rutgers New Jersey Medical School, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swae Skin, LLCGroup PAC ID 1658747456, 3 clinicians

Practice addresses (Care Compare)

30 Farrell St
Suite 200
South Burlington, VT 05403-6395
Phone (802) 355-9730

Hospital & facility affiliations

  • Univ. of Vermont - Fletcher Allen Health Care Hospital, Burlington, VT, CCN 470003

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
80.11
Improvement activities
40
Cost
88.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
0550030787VTMDSurgical Physician Assistant

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.

Hospital & facility affiliations 1

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1124048822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 MOUNTAIN VIEW DR",
            "address_2": "SUITE 300",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054465968",
            "telephone_number": "802-864-0192",
            "fax_number": "802-860-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 MOUNTAIN VIEW DR",
            "address_2": "SUITE 300",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054465968",
            "telephone_number": "802-864-0192",
            "fax_number": "802-860-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAWLIK",
        "first_name": "DAVID",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "PA-C, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VT",
            "license": "0550030787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colchester, VT

Sources for this page

Verify at the official NPI Registry.