Individual provider Active NPI

Gabrielle Cook, PA-C

  • Physician Assistant
  • Havertown, PA
National Provider Identifier
1508512211
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9115708 Issued in FL
Practice address
115 W Eagle Rd
Havertown, PA 19083-2272
Phone
(484) 452-9400
NPI assigned
Feb 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9115708 FL Primary

Addresses

Primary practice location

115 W Eagle Rd
Havertown, PA 19083-2272

Mailing address

115 W Eagle Rd
Havertown, PA 19083-2272
Phone (484) 452-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20231107000105 PA Practitioner - Physician Assistant 4183071566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pennsylvania Urgent Care Centers, PLLCGroup PAC ID 8123200631, 107 clinicians

Practice addresses (Care Compare)

150 E Pennsylvania Ave
Downingtown, PA 19335-2657
Phone (610) 518-1060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9115708FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dover Shores Family Practice Current 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1508512211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W EAGLE RD",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832272",
            "telephone_number": "484-452-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W EAGLE RD",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832272",
            "telephone_number": "484-452-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "GABRIELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-22",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havertown, PA

Sources for this page

Verify at the official NPI Registry.