Nicholas Gore, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

10625 W North Ave Ste 101B
Wauwatosa, WI 53226-2315

Phone

(414) 877-5350

NPI assigned

Aug 18, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Medicine Specialists SCGroup PAC ID 8729975461, 220 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051

Medicare enrollment (NPD)

Enrolled

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.

• Emergency Medicine Specialists, S.C.

  • Emergency Medicine Physician
  • Milwaukee, WI
  • NPI 1568413524
  Medicare reassignment Care Compare group
• EMS Observation, S.C.

  • Emergency Medicine Physician
  • Franklin, WI
  • NPI 1033858378
  NPD

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

• Columbia St. Mary'S Hospital Milwaukee, Inc.

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1871656082
  Care Compare affiliation

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

{
    "created_epoch": "1692316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1467236729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 N WILSON DR APT 2",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532111347",
            "telephone_number": "715-571-7743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10625 W NORTH AVE STE 101B",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262315",
            "telephone_number": "414-877-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORE",
        "first_name": "NICHOLAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-18",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerri Lynn Golinghorst, MD
• Heidi Jean Gonzalez
• Jennifer L Good, MD
• Carrie Beth Goodman, L.P.N.
• Kenneth B. Gordon, M.D.
• Melissa Gorman
• Robin Ann Gorman, DDS
• Aubrie Kalin Gorski, LPC-IT
• Karen Gotwalt, M.D.
• Bob Matthew Gountis, D.C.

• Physician Assistant in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.
• 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.