Individual provider Active NPI

Katherine Rose Gallivan, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1346846581
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA062216 Issued in PA
Practice address
51 North 39TH Street
3Rd Floor
Philadelphia, PA 19104-2640
Phone
(215) 662-9189
Fax
(215) 243-4612
NPI assigned
Dec 10, 2020
Last updated
Oct 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA062216 PA Primary

Addresses

Primary practice location

51 North 39TH Street
3Rd Floor
Philadelphia, PA 19104-2640

Mailing address

51 North 39TH Street
3Rd Floor
Philadelphia, PA 19104-2640
Phone (215) 662-9189

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
I20240722001720 PA Practitioner - Physician Assistant 7618380908 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

51 N 39TH St 4 HVP
Penn Cardiology Penn Presbyterian 4TH Floor
Philadelphia, PA 19104-2640
Phone (215) 662-9189

7133 Roosevelt Blvd
Philadelphia, PA 19149-1431
Phone (215) 333-5604

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.22 of 100Reported as apm
Quality
83.82
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA062216PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Jul 15, 2024 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst CurrentSince Oct 11, 2025 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Oct 11, 2025 Accepting new patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Jul 15, 2024 Accepting new patients

Locations

7133 Roosevelt Blvd
Philadelphia, PA 19149
Phone (215) 333-3311

701 E Marshall St
West Chester, PA 19380
Phone (610) 431-5000

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 6

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.

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": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1346846581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 NORTH 39TH STREET",
            "address_2": "3RD FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-9189",
            "fax_number": "215-243-4612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 NORTH 39TH STREET",
            "address_2": "3RD FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-9189",
            "fax_number": "215-243-4612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLIVAN",
        "first_name": "KATHERINE",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-10",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.