Kimberly Anita Gore, P.A.-C.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2625 Issued in FL

Practice address

30115 County Road 52 Ste 101
San Antonio, FL 33576-8243

Phone

(813) 467-4244

NPI assigned

Feb 14, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles (1 of 3)

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: kgore2589075@adventhealth.direct-ci.com

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.

• Florida Hospital Physician Group Inc

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1174955256

  FL

  Medicare reassignment Care Compare group
• Pritesh & Tarak P a

  • Specialist
  • New Port Richey, FL
  • NPI 1760680870

  FL

  Medicare reassignment
• West Central Gastroenterology LLP

  • Gastroenterology Physician
  • Clearwater, FL
  • NPI 1144454703

  FL

  Medicare reassignment
• Gastro Florida Pharmacy, LLC

  • Pharmacy
  • Clearwater, FL
  • NPI 1285272815
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University Community Hospital, Inc

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1053321919

  Hospital

  Care Compare affiliation
• University Community Hospital, Inc

  • Clinical Medical Laboratory
  • Tampa, FL
  • NPI 1134766694

  Hospital

  Care Compare affiliation

Specialty

Physician Assistant

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Hospital Physician Group Inc 953 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Tampa Hospital, Tampa, FL, CCN 100173

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1700929296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30115 COUNTY ROAD 52 STE 101",
            "city": "SAN ANTONIO",
            "state": "FL",
            "postal_code": "335768243",
            "telephone_number": "813-467-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30115 COUNTY ROAD 52 STE 101",
            "city": "SAN ANTONIO",
            "state": "FL",
            "postal_code": "335768243",
            "telephone_number": "813-467-4244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2919 W Swann Ave Ste 106",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336094049",
            "country_code": "US",
            "telephone_number": "813-930-2829",
            "fax_number": "813-930-9522",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6340 Fort King Rd",
            "address_purpose": "LOCATION",
            "city": "Zephyrhills",
            "state": "FL",
            "postal_code": "335422531",
            "country_code": "US",
            "telephone_number": "813-782-6116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORE",
        "first_name": "KIMBERLY",
        "middle_name": "ANITA",
        "name_prefix": "Miss",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA0002625",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA2625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in San Antonio, FL
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.