Gladys V Rodriguez Caraballo, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1020 Issued in NH

Practice address

207 S Main St
Newmarket, NH 03857-1835

Phone

(603) 292-7292

Fax

(603) 659-5892

NPI assigned

Jan 13, 2009

Last updated

Sep 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NH

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

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vantage Healthcare LLCGroup PAC ID 8224361191, 72 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cornerstone Vna Home health agency, Rochester, NH, CCN 307022
• Wentworth Home Care & Hospice, an Amedisys Partner Home health agency, Somersworth, NH, CCN 307014
• Elliot Hospital Hospital, Manchester, NH, CCN 300012

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Vantage Healthcare LLC

  dba Vantage Healthcare

  • Internal Medicine Physician
  • Canton, MA
  • NPI 1366903551

  NH

  Medicare reassignment Care Compare group
• Lamprey Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Newmarket, NH
  • NPI 1568412237
  Medicare reassignment
• Pai Participant 1 LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Chillicothe, OH
  • NPI 1093371312

  NH

  Medicare reassignment
• Lamprey Health Care Inc

  dba Healthy Together

  • Federally Qualified Health Center (FQHC)
  • Derry, NH
  • NPI 1710592977

  Medical

  NPD
• River Valley Infectious Disease Specialists Inc.

  • Infectious Disease Physician
  • Newburyport, MA
  • NPI 1366712002
  NPD (past)

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

• Cornerstone Vna

  • Home Health Agency
  • Rochester, NH
  • NPI 1508829045
  Care Compare affiliation
• Elliot Hospital of the City of Manchester

  • General Acute Care Hospital
  • Manchester, NH
  • NPI 1902996028
  Care Compare affiliation
• Wentworth Home Care and Hospice, LLC

  dba Wentworth Home Care and Hospice, an Amedisys Partner

  • Home Health Agency
  • Somersworth, NH
  • NPI 1568436194
  Care Compare affiliation

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

{
    "created_epoch": "1231804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1275770265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 S MAIN ST",
            "city": "NEWMARKET",
            "state": "NH",
            "postal_code": "038571835",
            "telephone_number": "603-292-3061",
            "fax_number": "603-659-5892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 S MAIN ST",
            "city": "NEWMARKET",
            "state": "NH",
            "postal_code": "038571835",
            "telephone_number": "603-292-7292",
            "fax_number": "603-659-5892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Hitchcock Way",
            "address_2": "Internal Medicine",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "03104",
            "country_code": "US",
            "telephone_number": "603-695-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ CARABALLO",
        "first_name": "GLADYS",
        "middle_name": "V",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-13",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NH",
            "license": "1020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3096848",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9001140",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rachael Despard Robertson, LICSW
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• Sandra K. Vallery, PHD
• Karen Schidlovsky
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• Jacob William Smith

• Medical Physician Assistant in Newmarket, NH
• Providers in Newmarket, NH by specialty
• Medical Physician Assistant in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.