Individual provider Active NPI

Preston Gene Gorman, P.A.

  • Medical Physician Assistant
  • Culpeper, VA
National Provider Identifier
1588008916
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110008225 Issued in VA
Practice address
1043 Oaklawn Dr Ste a
Culpeper, VA 22701-3339
Phone
(540) 613-1825
NPI assigned
Apr 29, 2013
Last updated
Apr 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA08373 TX
Medical Physician Assistant 363AM0700X 0110008225 VA Primary

Addresses

Primary practice location

1043 Oaklawn Dr Ste a
Culpeper, VA 22701-3339

Mailing address

1043 Oaklawn Dr Ste a
Culpeper, VA 22701-3339
Phone (540) 613-1825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130808000542 TX Practitioner - Physician Assistant 5991947681 Reassigns benefits to 2 organizations
I20260608002043 MT Practitioner - Physician Assistant 5991947681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4055 Valley View LN
Suite 700
Dallas, TX 75244-4910

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA08373TXMDPhysician Assistant
0110008225VAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Libertas Leadership LLC CurrentSince May 7, 2023 Accepting new patients
Bcep PA Past Accepting new patients

Locations

1043 Oaklawn Dr
Ste A
Culpeper, VA 22701
Phone (540) 403-8142

Interoperability endpoints

  • Direct secure messaging: preston.gorman.1@33469.direct.athenahealth.com

Organizations & group practices 4

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": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1588008916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 OAKLAWN DR STE A",
            "city": "CULPEPER",
            "state": "VA",
            "postal_code": "227013339",
            "telephone_number": "540-613-1825",
            "fax_number": "540-870-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 OAKLAWN DR STE A",
            "city": "CULPEPER",
            "state": "VA",
            "postal_code": "227013339",
            "telephone_number": "540-613-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "PRESTON",
        "middle_name": "GENE",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-29",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08373",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110008225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culpeper, VA

Sources for this page

Verify at the official NPI Registry.