Michelle L Gauntlett, PA-C
Individual provider Active NPI Medical Physician Assistant · Old Forge, PA
NPI 1487908950 · NPPES record last updated Jan 7, 2022
Key facts
- NPI
- 1487908950
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- OA001000 (PA)
- Practice address
- 821 S Main St
Suite3
Old Forge, PA 18518-1497 - Phone
- (570) 457-0562
- Fax
- (570) 457-0603
- NPI assigned
- Nov 5, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ramos Rheumatology PC
Practice addresses (Care Compare)
650 Main St
Avoca, PA 18641-1518
Phone (570) 471-3352
Hospital & facility affiliations
- Wilkes-Barre General Hospital
- Wayne Memorial Hospital
- Regional Hospital of Scranton
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041213000103 | PA | Practitioner - Physician Assistant | 5092772053 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OA001000 | PA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pinnacle Rehabilitation Associates PC | Past |
Accepting new patients |
Interoperability endpoints
- mguantlett@ramosrheum.medentdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | OA001000 | PA | Yes |
Addresses
Primary practice location
821 S Main St
Suite3
Old Forge, PA 18518-1497
Mailing address
650 Main St
Avoca, PA 18641-1518
Phone (570) 471-3352
Other providers in Old Forge, PA
- Deborah Ferri
- Jeffrey Frail
- Krista Lynn Galella
- Robin Gallagher
- Gina Gatto-Harris
- Kristina Grande
- Marilou Grant
- Anthony J Grasso Jr.
- Graziano Chiropractic
- Lana Grzybicki
All providers in Old Forge, PA · Medical Physician Assistant in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.