Monica C Gavin, MD
Individual provider Active NPI Pediatrics Physician · Coplay, PA
NPI 1881637577 · NPPES record last updated Jun 5, 2010
Key facts
- NPI
- 1881637577
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- MD061743L (PA)
- Practice address
- 17 N 3Rd St
Coplay, PA 18037-1524 - Phone
- (610) 200-8183
- Fax
- (610) 530-0151
- NPI assigned
- Jun 13, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160512000912 | PA | Order and Referring Only - Pediatric Medicine |
6406145580 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alc of Lehigh Valley Inc | Past | Accepting new patients | |
| Gavin Health Inc | Pediatrics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD061743L | PA | Yes |
Addresses
Primary practice location
17 N 3Rd St
Coplay, PA 18037-1524
Mailing address
3067 Jordan Rd
Orefield, PA 18069-2261
Phone (610) 530-0151
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1637311 | Medicaid | PA | |
| 968579 | Other | PA | HIGHMARK INDV NUMBER |
Other providers in Coplay, PA
- Christin Ann Delahay
- Susan Louise Dillmuth-Miller
- Divine Guidance Support Inc.
- Coleen Jo Forte
- Gavin Health Inc
- Judith Henriquez-Valerio
- Susan M Horn
- Independence Corp
- Jonn Healthcare Agency LLC
- Jason Kishbaugh
All providers in Coplay, PA · Pediatrics Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.