Individual provider Active NPI

Pamela A Gentile, PT, MS, ATC

  • Physical Therapist
  • Erie, PA
National Provider Identifier
1467451674
Registry record updated Jun 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT001140E Issued in PA
Practice address
5100 Peach St
Erie, PA 16509-2482
Phone
(814) 864-5097
Fax
(814) 864-9583
NPI assigned
Jul 19, 2005
Last updated
Jun 13, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT001140E PA Primary

Addresses

Primary practice location

5100 Peach St
Erie, PA 16509-2482

Mailing address

1600 Peninsula Dr
Erie, PA 16505-4261
Phone (814) 864-5097

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PT001140EPAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Vincent Rehab Solutions LLC Physical Therapist Past Accepting new patients
St Vincent Medical Education and Research Institute Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371081600000",
    "number": "1467451674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 PENINSULA DR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165054261",
            "telephone_number": "814-864-5097",
            "fax_number": "814-864-9583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092482",
            "telephone_number": "814-864-5097",
            "fax_number": "814-864-9583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTILE",
        "first_name": "PAMELA",
        "middle_name": "A",
        "credential": "PT, MS, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-19",
        "last_updated": "2013-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT001140E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.