Individual provider Active NPI

Anna M Gatewood, PA-C

  • Physician Assistant
  • Middletown, CT
National Provider Identifier
1962665570
Registry record updated Jan 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
000829 Issued in CT
Practice address
57 S Main St
Middletown, CT 06457-3606
Phone
(860) 638-0050
Fax
(860) 358-9140
NPI assigned
Jul 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 000829 CT Primary

Addresses

Primary practice location

57 S Main St
Middletown, CT 06457-3606

Mailing address

57 S Main St
Middletown, CT 06457-3606
Phone (860) 638-0050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20040621000540 CT Practitioner - Physician Assistant 8820073380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiologic Associates of Middletown PCGroup PAC ID 5799765186, 32 clinicians

Practice addresses (Care Compare)

28 Crescent St
Middletown, CT 06457-3654
Phone (860) 344-6293

57 S Main St
Middletown, CT 06457-3606
Phone (860) 346-8481

Merit-based Incentive Payment System (MIPS)

Final score
50.32 of 100Reported as group
Quality
38.88
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
829CTMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Guilford Radiology LLC PastSince Aug 1, 2018 Accepting new patients
MHS Primary Care Inc Physician Assistant Past Accepting new patients

Organizations & group practices 3

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": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1962665570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 S MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573606",
            "telephone_number": "860-638-0050",
            "fax_number": "860-358-9140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 S MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573606",
            "telephone_number": "860-638-0050",
            "fax_number": "860-358-9140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATEWOOD",
        "first_name": "ANNA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "000829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.