Katherine Elizabeth Gambino, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-04451 Issued in NC

Practice address

123 Capcom Ave Ste 105
Wake Forest, NC 27587-6517

Phone

(919) 263-8510

NPI assigned

Dec 19, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

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 and National Provider Directory roles.

• Wakemed Specialists Group LLC

  dba WakeMed - Virtual Cardiac Rehab

  • Cardiac Rehabilitation Registered Nurse
  • Raleigh, NC
  • NPI 1063304228
  NPD
• Wakemed Specialists Group, LLC

  • Neonatal-Perinatal Medicine Physician
  • Raleigh, NC
  • NPI 1649834102
  NPD
• Southern Gastroenterology Endoscopy Center, P.C.

  • Ambulatory Surgical Clinic/Center
  • South Boston, VA
  • NPI 1265137517
  NPD (past)

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

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1285970236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CELESTINE PL",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275024834",
            "telephone_number": "231-838-8413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 CAPCOM AVE STE 105",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876517",
            "telephone_number": "919-263-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBINO",
        "first_name": "KATHERINE",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-19",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285970236",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• G. Christopher Martin DDS, PA II
• Sally Martin Gadd, LPC
• Gahc3 Wake Forest NC TRS Sub, LLC (Cadence at Wake Forest)
• Edward Michael Galiczynski Jr., DO
• Sheila Marie Gallagher-Whitlock, PT
• Meghan Lucy Clair Gamelin, M.D.
• Ganglani Wake Forest PLLC (Supremia Dentistry)
• Cameron Yessenia Garcia
• Austin John Gardner, PT, DPT
• Robert W Gardner, M.D.

• Physician Assistant in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.