Individual provider Active NPI

Lauren Nicole Gamble, PA-C

  • Physician Assistant
  • League City, TX
National Provider Identifier
1790189561
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA09509 Issued in TX
Practice address
2240 Gulf Fwy S
League City, TX 77573
Phone
(832) 505-1600
Fax
(281) 309-0419
NPI assigned
Oct 22, 2014
Last updated
Jun 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 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 PA09509 TX Primary
Surgical Physician Assistant 363AS0400X 085.007056 IL

Addresses

Primary practice location

2240 Gulf Fwy S
League City, TX 77573

Mailing address

PO Box 650859
Dept 710
Dallas, TX 75265
Phone (409) 772-2222

Other practice location 1

1515 Holcombe Blvd
Houston, TX 77030-4009
Phone (713) 792-6161

Other practice location 2

680 N Lake Shore Dr
Chicago, IL 60611
Phone (312) 695-6868

Other identifiers 2

IdentifierTypeStateIssuer
8525NUOtherTXBCBS
342568802MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150204001673 TX Practitioner - Physician Assistant 0042535577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utmb Faculty Group PracticeGroup PAC ID 3375456734, 1,083 clinicians

Practice addresses (Care Compare)

301 University Blvd
Galveston, TX 77555-5302
Phone (409) 772-2222

PO Box
650859 Dept 710
Dallas, TX 75265-0859

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.88 of 100Reported as group
Quality
73.38
Improvement activities
40
Cost
78.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085.007056ILMDSurgical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: lgamblepac24004@direct.utmb.edu

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1790189561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650859",
            "address_2": "DEPT 710",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75265",
            "telephone_number": "409-772-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 GULF FWY S",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "77573",
            "telephone_number": "832-505-1600",
            "fax_number": "281-309-0419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 Holcombe Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770304009",
            "country_code": "US",
            "telephone_number": "713-792-6161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "680 N Lake Shore Dr",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60611",
            "country_code": "US",
            "telephone_number": "312-695-6868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "LAUREN",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-22",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09509",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085.007056",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8525NU",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "342568802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in League City, TX

Sources for this page

Verify at the official NPI Registry.