Individual provider Active NPI

Katherine Anne Gargiulo, M.D.

  • Pediatrics Physician
  • Yardley, PA
National Provider Identifier
1700044047
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MT189401 Issued in PA
Practice address
680 Heacock Rd Ste 101
Yardley, PA 19067-6346
Phone
(215) 493-8040
NPI assigned
May 22, 2008
Last updated
Mar 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA08729400 NJ
Pediatrics Physician 208000000X MT189401 PA Primary

Addresses

Primary practice location

680 Heacock Rd Ste 101
Yardley, PA 19067-6346

Mailing address

PO Box 13579
Reading, PA 19612-3579
Phone (484) 628-1324

Other practice location 1

710 Kresson Rd
Cherry Hill, NJ 08003-2604
Phone (856) 795-3320

Other names 1

  • Ms. Katherine Anne Passantino Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230413002120 NJ Practitioner - Pediatric Medicine 0749668465 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA08729400NJMDPediatrics Physician
MT189401PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
STC Pediatrics LLC Pediatrics Current Accepting new patients
STC Pediatrics LLC Pediatrics CurrentSince Jul 1, 2022 Accepting new patients
Advocare, LLC Pediatrics CurrentSince May 15, 2023 Accepting new patients
Advocare , LLC CurrentSince May 15, 2023 Accepting new patients
STC Pediatrics LLC Pediatrics CurrentSince Jul 1, 2022 Accepting new patients
Advocare, LLC Pediatrics Past Accepting new patients

Locations

710 Kresson Rd
Cherry Hill, NJ 08003
Phone (856) 795-3320

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

25 Lindsley Dr
Ste 205
Morristown, NJ 07960
Phone (973) 993-8777

431 Sicklerville Rd
Sicklerville, NJ 08081
Phone (856) 875-7444

300 E Hunting Park Ave
Philadelphia, PA 19124
Phone (215) 427-8363

680 Heacock Rd
Ste 101
Yardley, PA 19067
Phone (215) 493-6519

Interoperability endpoints

  • Direct secure messaging: katherine.gargiulo@advocaredoctors.eclinicaldirectplus.com

Organizations & group practices 6

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": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1700044047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579",
            "telephone_number": "484-628-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 HEACOCK RD STE 101",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190676346",
            "telephone_number": "215-493-8040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "710 Kresson Rd",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080032604",
            "country_code": "US",
            "telephone_number": "856-795-3320",
            "fax_number": "856-795-1213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARGIULO",
        "first_name": "KATHERINE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-22",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA08729400",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT189401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "PASSANTINO",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Yardley, PA

Sources for this page

Verify at the official NPI Registry.