Individual provider Active NPI

Gina M Fulgenzio, PA-C

  • Medical Physician Assistant
  • Erie, PA
National Provider Identifier
1639549710
Registry record updated Jan 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA057895 Issued in PA
Practice address
120 E 2ND St FL 2
Erie, PA 16507-1537
Phone
(814) 456-8980
Fax
(814) 451-0443
NPI assigned
Oct 1, 2015
Last updated
Jan 31, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X OA003645 PA
Medical Physician Assistant 363AM0700X MA057895 PA Primary

Addresses

Primary practice location

120 E 2ND St FL 2
Erie, PA 16507-1537

Mailing address

120 E 2ND St FL 2
Erie, PA 16507-1537
Phone (814) 456-8980

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
I20151202001997 PA Practitioner - Physician Assistant 4082914783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Health Services IncGroup PAC ID 4880593722, 572 clinicians

Practice addresses (Care Compare)

201 State St
Erie, PA 16550-0002
Phone (814) 877-6000

3406 Peach St
Erie, PA 16508-2740
Phone (814) 877-5381

Merit-based Incentive Payment System (MIPS)

Final score
81.89 of 100Reported as group
Quality
65.8
Promoting interoperability
100
Improvement activities
40
Cost
73.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OA003645PAMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: gfulgenzio95304@upmc.direct-ci.com
  • Direct secure messaging: gina.fulgenzio@upmcdirect.com

Organizations & group practices 1

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": "1443657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1639549710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E 2ND ST FL 2",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071537",
            "telephone_number": "814-456-8980",
            "fax_number": "814-451-0443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E 2ND ST FL 2",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071537",
            "telephone_number": "814-456-8980",
            "fax_number": "814-451-0443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULGENZIO",
        "first_name": "GINA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-01",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "OA003645",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA057895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.