NPIMap

Individual provider Active NPI

Michelle L Gauntlett, PA-C

  • Medical Physician Assistant
  • Old Forge, PA
National Provider Identifier
1487908950
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
OA001000 Issued in 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
Last updated
Jan 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X OA001000 PA Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041213000103 PA Practitioner - Physician Assistant 5092772053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ramos Rheumatology PCGroup PAC ID 7315175957, 4 clinicians

Practice addresses (Care Compare)

650 Main St
Avoca, PA 18641-1518
Phone (570) 471-3352

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Rehabilitation Associates PC PastSince Jan 17, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mguantlett@ramosrheum.medentdirect.com

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.

Hospital & facility affiliations 5

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": "1352073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1487908950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 MAIN ST",
            "city": "AVOCA",
            "state": "PA",
            "postal_code": "186411518",
            "telephone_number": "570-471-3352",
            "fax_number": "570-471-7873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 S MAIN ST",
            "address_2": "SUITE3",
            "city": "OLD FORGE",
            "state": "PA",
            "postal_code": "185181497",
            "telephone_number": "570-457-0562",
            "fax_number": "570-457-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUNTLETT",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-05",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "OA001000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Forge, PA

Sources for this page

Verify at the official NPI Registry.