Individual provider Active NPI

Corinne Rose Gercken, PA-C

  • Physician Assistant
  • Conshohocken, PA
National Provider Identifier
1811647696
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
400 Fayette St Ste 180
Conshohocken, PA 19428-2186
Phone
(833) 348-6937
NPI assigned
Mar 25, 2022
Last updated
May 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

400 Fayette St Ste 180
Conshohocken, PA 19428-2186

Mailing address

1111 Macbeth CT
Bel Air, MD 21015-1573
Phone (443) 866-2556

Other practice location 1

4808 Edgmont Ave
Brookhaven, PA 19015-1400
Phone (610) 876-3072

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
I20220418002209 PA Practitioner - Physician Assistant 2062809296 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

1840 S St
Philadelphia, PA 19146-7411
Phone (215) 893-7085

3400 Spruce St
Philadelphia, PA 19104-4206

3400 Spruce Street 5 White BLDG
Oral and Maxillofacial Surgery Hup
Philadelphia, PA 19104-4206
Phone (215) 829-6079

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medexpress Urgent Care, PC - Pennsylvania CurrentSince Nov 1, 2023 Accepting new patients
University of Penn-Medical Group CurrentSince Jun 2, 2025 Accepting new patients
University of Penn-Medical Group CurrentSince Jun 2, 2025 Accepting new patients
Medexpress Urgent Care, PC - Pennsylvania CurrentSince Nov 1, 2023 Accepting new patients

Locations

4808 Edgmont Ave
Brookhaven, PA 19015
Phone (610) 876-3072

1800 Lombard St
Philadelphia, PA 19146
Phone (215) 545-4173

7219 McKnight Rd
Ste F
Pittsburgh, PA 15237
Phone (412) 367-3278

Organizations & group practices 8

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": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1811647696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MACBETH CT",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210151573",
            "telephone_number": "443-866-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 FAYETTE ST STE 180",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282186",
            "telephone_number": "833-348-6937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4808 Edgmont Ave",
            "address_purpose": "LOCATION",
            "city": "Brookhaven",
            "state": "PA",
            "postal_code": "190151400",
            "country_code": "US",
            "telephone_number": "610-876-3072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GERCKEN",
        "first_name": "CORINNE",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-25",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conshohocken, PA

Sources for this page

Verify at the official NPI Registry.