NPIMap

Individual provider Active NPI

Gilbert M Mamauag, M.D.

  • Emergency Medicine Physician
  • London, KY
National Provider Identifier
1922056464
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
31417 Issued in KY
Practice address
346 Beechwood Dr
London, KY 40744-5403
Phone
(859) 227-7666
Fax
(606) 864-4774
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 31417 KY
Emergency Medicine Physician 207P00000X 31417 KY Primary

Addresses

Primary practice location

346 Beechwood Dr
London, KY 40744-5403

Mailing address

PO Box 370
London, KY 40743-0370
Phone (859) 227-7666

Other practice location 1

310 N L Rogers Wells Blvd
Glasgow, KY 42141-1300
Phone (270) 659-5555

Other identifiers 3

IdentifierTypeStateIssuer
000000526857OtherKYANTHEM BCBS
6431417200MedicaidKY
000000525342OtherKYANTHEM BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040524001459 KY Practitioner - Emergency MedicinePractitioner - Internal Medicine 4981685278 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31417KYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
T J Samson Community Hospital Current Accepting new patients
Emergency Medicine Services of Ky, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Emergency Medicine Physicians of Estill County,PLLC Emergency Medicine CurrentSince Jan 14, 2020 Accepting new patients
Pyma Medical, PLLC PastSince Feb 1, 2006 Accepting new patients
Juniper Hill Park Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Ky-I Medical Services, P.S.C. Past Accepting new patients
United Emergency Services, Inc. Emergency Medicine Past Accepting new patients
Williamson Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Marshall Emergency Services Associates, PLLC Emergency Medicine Past Accepting new patients
Memorial Hospital Inc. Internal Medicine Past Accepting new patients
Emergency Coverage, LLC Emergency Medicine Past Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Physicians Express Care Billing Past Accepting new patients
Eastern Kentucky Emergency Physicians, LLC Emergency Medicine Past Accepting new patients

Locations

1801 Ashley Cir
Bowling Green, KY 42104
Phone (270) 781-4330

1301 N Race St
Glasgow, KY 42141
Phone (270) 651-4141

299 Kings Daughters Dr
Hatton, KY 40601
Phone (502) 875-5240

60 Mercy Ct
Irvine, KY 40336
Phone (606) 723-2115

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1922056464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407430370",
            "telephone_number": "859-227-7666",
            "fax_number": "606-864-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 BEECHWOOD DR",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407445403",
            "telephone_number": "859-227-7666",
            "fax_number": "606-864-4774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 N L Rogers Wells Blvd",
            "address_purpose": "LOCATION",
            "city": "Glasgow",
            "state": "KY",
            "postal_code": "421411300",
            "country_code": "US",
            "telephone_number": "270-659-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAMAUAG",
        "first_name": "GILBERT",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "31417",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "31417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000526857",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6431417200",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000525342",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in London, KY

Sources for this page

Verify at the official NPI Registry.