Individual provider Active NPI

Lauremnesal Catre Gamolo, NP

  • Nurse Practitioner
  • Reisterstown, MD
National Provider Identifier
1174290258
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R179498 Issued in MD
Practice address
12332 Diploma Dr
Reisterstown, MD 21136-6027
Phone
(443) 742-1263
NPI assigned
Aug 25, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R179498 MD Primary

Addresses

Primary practice location

12332 Diploma Dr
Reisterstown, MD 21136-6027

Mailing address

12332 Diploma Dr
Reisterstown, MD 21136-6027
Phone (443) 742-1263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20211014002473 MD Practitioner - Nurse Practitioner 3072911403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
International Neurorehabilitation InstituteGroup PAC ID 3476784190, 3 clinicians

Practice addresses (Care Compare)

1447 York Rd
Suite 508
Lutherville, MD 21093-6022
Phone (410) 828-4629

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
International Neurorehabilitation Institute CurrentSince Nov 1, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1447 York Rd
Ste 508
Lutherville Timonium, MD 21093
Phone (410) 828-4629

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.

NPI Registry JSON

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1174290258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12332 DIPLOMA DR",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211366027",
            "telephone_number": "443-742-1263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12332 DIPLOMA DR",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211366027",
            "telephone_number": "443-742-1263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMOLO",
        "first_name": "LAUREMNESAL",
        "middle_name": "CATRE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R179498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reisterstown, MD

Sources for this page

Verify at the official NPI Registry.