Kaitlyn Ann Gresko

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA063030 Issued in PA

Practice address

2360 Maryland Rd
Willow Grove, PA 19090-1709

Phone

(215) 657-6776

NPI assigned

Mar 30, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Philadelphia Col of Osteo Med, Sewanee, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trinity Health Mid-Atlantic Medical GroupGroup PAC ID 7416861885, 350 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary Medical Center Hospital, Langhorne, PA, CCN 390258

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kgresko3291721@direct.trinity-health.org

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.

• Trinity Health Mid-Atlantic Medical Group

  dba THMA MG Surgical Associates Holme

  • Surgery Physician
  • Langhorne, PA
  • NPI 1972982361
  Medicare reassignment Care Compare group NPD (past)
• MHP MD PLLC

  dba AFC Urgent Care

  • Urgent Care Clinic/Center
  • Conshohocken, PA
  • NPI 1508538695
  Medicare reassignment
• Rheumatic Disease Associates,LTD

  • Rheumatology Physician
  • Willow Grove, PA
  • NPI 1235116344
  Medicare reassignment
• Tower Health Urgent Care, LLC

  • Emergency Medicine Physician
  • Douglassville, PA
  • NPI 1194293647
  Medicare reassignment
• Trinity Health Mid-Atlantic Medical Group

  dba Nazareth Health Residency Center

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1497312656
  NPD
• Trinity Health Mid-Atlantic Medical Group

  • Physical Medicine & Rehabilitation Physician
  • Philadelphia, PA
  • NPI 1639039175
  NPD
• Trinity Health Mid-Atlantic Medical Group

  dba THMA MG Trauma Service Langhorne

  • Trauma Surgery Physician
  • Langhorne, PA
  • NPI 1093771271
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Mary Medical Center

  • General Acute Care Hospital
  • Langhorne, PA
  • NPI 1780686931
  Care Compare affiliation

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1205414455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 MARYLAND RD",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 MARYLAND RD",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901709",
            "telephone_number": "215-657-6776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1203 Langhorne Newtown Rd Ste 225",
            "address_purpose": "LOCATION",
            "city": "Langhorne",
            "state": "PA",
            "postal_code": "190471237",
            "country_code": "US",
            "telephone_number": "215-710-6613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRESKO",
        "first_name": "KAITLYN",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA063030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenn Gordon, MSPT
• Rachel Goren, MA, LPC
• Brianna Gotwalt
• Wendolyn Ruthe Grace, RN., CRNP.
• Vivian N. Greenberg, M.D.
• Michelle Grinberg, DPT
• Corey J Grink, D.C.
• Joseph Howard Gronich, MD
• Megan O'Connor Grugan, CRNP
• GS Rehab & Nursing Center LLC (Garden Spring Nursing and Rehabilitation Center)

• Physician Assistant in Willow Grove, PA
• Providers in Willow Grove, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.