Kathryn G Gallo, PA
Individual provider Active NPI Physician Assistant · Broadway, VA
NPI 1609367135 · NPPES record last updated Nov 19, 2020
Key facts
- NPI
- 1609367135
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0110006244 (VA)
- Practice address
- 13892 Timber Way
Broadway, VA 22815 - Phone
- (540) 901-0800
- NPI assigned
- May 21, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Martha Jefferson Medical Group LLC
Select Physical Therapy Holdings Inc
Practice addresses (Care Compare)
1646 Park Ridge Dr
Crozet, VA 22932-3155
Phone (434) 654-2760
250 Merchant Walk SQ
Suite 1103
Charlottesville, VA 22902-6511
Phone (434) 328-4900
Hospital & facility affiliations
- Sentara Martha Jefferson Hospital
- University of Virginia Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- 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 |
|---|---|---|---|---|
| I20180830003725 | VA | Practitioner - Physician Assistant | 1557611142 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Martha Jefferson Hospital | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | 0110006244 | VA | Yes |
Addresses
Primary practice location
13892 Timber Way
Broadway, VA 22815
Mailing address
PO Box 1430
Harrisonburg, VA 22803-1430
Phone (540) 901-0800
Other practice location 1
315 10th St NE
Charlottesville, VA 22902-5316
Phone (434) 654-1950
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609367135 | Medicaid | VA |
Other names
- Kathryn G Vasco
Other providers in Broadway, VA
- Sean P Daugherty
- Shana Sherman Daugherty
- Miguel A Delgado
- Donald E. Rellins, Jr. DDS PC
- Jessica Lynn Dove
- Tabitha T Garrison
- Grindstone Counseling, LLC
- Jennifer Lee Grove
- Robert Dover Harris
- Todd Hedinger
All providers in Broadway, VA · Physician Assistant in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2020. 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.