Individual provider Active NPI

Paul Wesley Gill, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Severna Park, MD
National Provider Identifier
1891864005
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
1032 Issued in MD
Practice address
580 Ritchie Hwy Ste K
Severna Park, MD 21146-3926
Phone
(410) 544-8433
Fax
(410) 544-9026
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 1032 MD Primary

Addresses

Primary practice location

580 Ritchie Hwy Ste K
Severna Park, MD 21146-3926

Mailing address

580 Ritchie Hwy Ste K
Severna Park, MD 21146-3926
Phone (410) 544-8433

Other identifiers 5

IdentifierTypeStateIssuer
4362987OtherMDAETNA USHC
480030924OtherMDMEDICARE RAILROAD
A824 0001OtherFLDC BLUE CROSS FEP
UNITED HEALTH CAREOtherMD339009
40147604OtherMDCAREFIRST MD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111213000132 MD Practitioner - Podiatry 7214057231 Reassigns benefits to 1 organization
O20100930085166 MD DME Supplier - Physician - Podiatry 8123148145 Practice locations: Severna Park, MD

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1032MDMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Paul W Gill DPM PC CurrentSince Jun 29, 2016 Accepting new patients

Locations

580 Ritchie Hwy
Ste K
Severna Park, MD 21146
Phone (410) 544-8433

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1891864005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 RITCHIE HWY STE K",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463926",
            "telephone_number": "410-544-8433",
            "fax_number": "410-544-9026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 RITCHIE HWY STE K",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463926",
            "telephone_number": "410-544-8433",
            "fax_number": "410-544-9026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "PAUL",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MD",
            "license": "1032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA USHC",
            "identifier": "4362987",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "480030924",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DC BLUE CROSS FEP",
            "identifier": "A824 0001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "339009",
            "identifier": "UNITED HEALTH CARE",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD",
            "identifier": "40147604",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

Verify at the official NPI Registry.