Individual provider Active NPI

Andrea N. Gill, PA-C

  • Physician Assistant
  • Gary, IN
National Provider Identifier
1275540064
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50-002472 Issued in OH
Practice address
600 Grant St
Gary, IN 46402-6001
Phone
(219) 886-4289
NPI assigned
Aug 2, 2006
Last updated
Aug 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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 50-002472 OH Primary
Physician Assistant 363A00000X 10001135A IN

Addresses

Primary practice location

600 Grant St
Gary, IN 46402-6001

Mailing address

600 Grant St
Gary, IN 46402-6001
Phone (219) 886-4289

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20110125000328 IN Practitioner - Physician Assistant 1850397464 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50-002472OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Sep 1, 2019 Accepting new patients
Cep America LLC CurrentSince Sep 1, 2019 Accepting new patients
Emergency Services, Inc. Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1275540064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 GRANT ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464026001",
            "telephone_number": "219-886-4289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRANT ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464026001",
            "telephone_number": "219-886-4289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "ANDREA",
        "middle_name": "N.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50-002472",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001135A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gary, IN

Sources for this page

Verify at the official NPI Registry.