Active NPI
Gabrielle Elizabeth Massimo, PA-C
- Physician Assistant
- Eagleville, PA
National Provider Identifier
1396465886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA063538
- Practice address
- 60 Eagleville Rd
Eagleville, PA 19403-1403 - Phone
- (610) 635-7100
- NPI assigned
- Sep 2, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA063538 | PA | Primary |
Addresses
Primary practice location
60 Eagleville Rd
Eagleville, PA 19403-1403
Mailing address
4415 Lobella CT
Chester Springs, PA 19425-3907
Phone (610) 733-0750
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA063538 | PA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662940800000",
"number": "1396465886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4415 LOBELLA CT",
"city": "CHESTER SPRINGS",
"state": "PA",
"postal_code": "194253907",
"telephone_number": "610-733-0750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 EAGLEVILLE RD",
"city": "EAGLEVILLE",
"state": "PA",
"postal_code": "194031403",
"telephone_number": "610-635-7100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASSIMO",
"first_name": "GABRIELLE",
"middle_name": "ELIZABETH",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-02",
"last_updated": "2022-09-12",
"certification_date": "2022-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA063538",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagleville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.