Kirk F Gautier, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA03984 Issued in TX

Practice address

805 S Palestine St
Athens, TX 75751-3427

Phone

(903) 534-6200

Fax

(903) 939-0755

NPI assigned

Jul 2, 2006

Last updated

Aug 4, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Oliver Street 5.01(a) Inc.

  dba U.S. Dermatology Partners

  • Dermatology Physician
  • Dallas, TX
  • NPI 1457695413
  Medicare reassignment Care Compare group
• Lawrence L Anderson MD PA

  dba Dermatology Associates Of Tyler

  • Dermatology Physician
  • Tyler, TX
  • NPI 1932134079
  NPD (past)

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501804800000",
    "number": "1821027798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1367 DOMINION PLAZA",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 S PALESTINE ST",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757513427",
            "telephone_number": "903-534-6200",
            "fax_number": "903-939-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTIER",
        "first_name": "KIRK",
        "middle_name": "F",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2017-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert L Gage, RN, BSN
• Jorge Gamez Jr., M.D.
• Vanessa Crystal Garcia-Balok, O.D.
• Ruben Luis Garcia Jr., M.D.
• Melissa Ann Garrett, RN, FNP-C
• Renessa Leigh Gerhardt, MD
• Gibson Pharmacy, LLC (Anderson's Gibson Pharmacy)
• Gibson Pharmacy, LLC (Anderson's Gibson Pharmacy)
• Tyler Ann Gipson, PHARMD
• Glory Kendi Gituma, CRNA

• Physician Assistant in Athens, TX
• Providers in Athens, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2017; 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.