Elisabeth Luise Gammelin, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-448 Issued in ID

Practice address

1 Lake Station
Lake Clinic
Yellowstone National Park, WY 82190

Phone

(307) 242-7241

Fax

(307) 242-7273

NPI assigned

Nov 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID, WY2 enrollments

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 2

Specialty

Physician Assistant

Education

University of New England, College of Osteo Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stgi Health, LLCGroup PAC ID 1850764226, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Stgi Health, LLC

  • Primary Care Clinic/Center
  • Yellowstone National Park, WY
  • NPI 1427766427
  Medicare reassignment Care Compare group
• Teton Valley Health Care Inc

  • Rural Health Clinic/Center
  • Driggs, ID
  • NPI 1013264183
  Medicare reassignment NPD
• Teton Valley Health Care, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Driggs, ID
  • NPI 1053669598
  NPD
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)
• Medical Imaging Associates of Idaho Falls, Inc

  • Diagnostic Radiology Physician
  • Pocatello, ID
  • NPI 1740225531
  NPD (past)
• Teton Valley Health Care Inc

  • Critical Access Hospital
  • Driggs, ID
  • NPI 1477809622
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243900800000",
    "number": "1902975055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "283 N 1ST E",
            "city": "DRIGGS",
            "state": "ID",
            "postal_code": "834225109",
            "telephone_number": "208-354-2302",
            "fax_number": "208-354-8392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LAKE STATION",
            "address_2": "LAKE CLINIC",
            "city": "YELLOWSTONE NATIONAL PARK",
            "state": "WY",
            "postal_code": "82190",
            "telephone_number": "307-242-7241",
            "fax_number": "307-242-7273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMMELIN",
        "first_name": "ELISABETH",
        "middle_name": "LUISE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2009-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806724500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen Chappelle Caughron, MD
• Elisabeth Edelstein, MD
• Kurt Smith Frantz, M.D.
• Stgi Health, LLC
• Stgi Health, LLC
• Stgi Health, LLC
• US Department of the Interior, National Park Service

• Physician Assistant in Yellowstone National Park, WY
• Providers in Yellowstone National Park, WY by specialty
• Physician Assistant in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; 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.