Individual provider Active NPI

Karlee Ann Gavrish, PA-C

  • Physician Assistant
  • Kingston, PA
National Provider Identifier
1225540917
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
560 Pierce St
Kingston, PA 18704
Phone
(570) 283-2161
Fax
(570) 714-0670
NPI assigned
Nov 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

560 Pierce St
Kingston, PA 18704

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other practice location 1

41 Shoemaker St
Forty Fort, PA 18704-4127
Phone (570) 239-9564

Other practice location 2

41 Shoemaker St
Forty Fort, PA 18704-4127
Phone (570) 239-9564

Other names 1

  • Miss Karlee Ann Conforti Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kgavrish192029@direct.geisinger.edu Direct
Direct Messaging Address kgavrish192029@direct.geisinger.edu Direct

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
I20191002002632 PA Practitioner - Physician Assistant 4789914813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

114 LT Michael Cleary Dr
Dallas, PA 18612-1649
Phone (570) 255-1178

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

499 Wyoming Ave
Kingston, PA 18704-3602
Phone (570) 283-2161

560 Pierce St
Kingston, PA 18704-5716
Phone (570) 714-5810

Hospital & facility affiliations

  • Wilkes-Barre General Hospital Hospital, Wilkes-Barre, PA, CCN 390137

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Sep 16, 2019 Accepting new patients
Geisinger Clinic CurrentSince Sep 16, 2019 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

114 Lt Michael Cleary Dr
Dallas, PA 18612
Phone (570) 255-1178

100 N Academy Ave
Danville, PA 17822

499 Wyoming Ave
Kingston, PA 18704
Phone (570) 283-2161

560 Pierce St
Kingston, PA 18704
Phone (570) 283-2161

4004 Birney Ave
Moosic, PA 18507
Phone (570) 344-4711

126 Market Way
Mount Pocono, PA 18344
Phone (570) 839-3633

42 N Main St
Pittston, PA 18640
Phone (570) 602-5610

531 Mt Pleasant Dr
Scranton, PA 18503
Phone (570) 342-8500

50 Roosevelt Ter
Wilkes Barre, PA 18702
Phone (570) 808-8780

1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300

35 S Mountain Blvd
Wilkes Barre, PA 18707
Phone (570) 474-5072

Interoperability endpoints

  • Direct secure messaging: kgavrish192029@direct.geisinger.edu

Organizations & group practices 4

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 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": "1509580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1225540917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 PIERCE ST",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "18704",
            "telephone_number": "570-283-2161",
            "fax_number": "570-714-0670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Shoemaker St",
            "address_purpose": "LOCATION",
            "city": "Forty Fort",
            "state": "PA",
            "postal_code": "187044127",
            "country_code": "US",
            "telephone_number": "570-239-9564",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "41 Shoemaker St",
            "address_purpose": "LOCATION",
            "city": "Forty Fort",
            "state": "PA",
            "postal_code": "187044127",
            "country_code": "US",
            "telephone_number": "570-239-9564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAVRISH",
        "first_name": "KARLEE",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-02",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgavrish192029@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "560 Pierce St",
            "city": "Kingston",
            "state": "PA",
            "country_code": "US",
            "postal_code": "18704",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgavrish192029@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "560 Pierce St",
            "city": "Kingston",
            "state": "PA",
            "country_code": "US",
            "postal_code": "18704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KARLEE",
            "last_name": "CONFORTI",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kingston, PA

Sources for this page

Verify at the official NPI Registry.