KATHLEEN GORMAN (NNP) – Neonatal Nurse Practitioner, NPI 1114984093
Neonatal Nurse Practitioner
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
7,509 NURSE PRACTITIONER in AZ
Provider Addresses for KATHLEEN GORMAN (NNP)
901 E Willetta St
Ste. 2503
Phoenix, AZ 850062727
Phone: (602) 239-5166
Fax: (602) 239-2307
Type: Location
2315 Stockton Blvd
Sacramento, CA 958172201
Phone: (916) 734-2011
Type: Location
1840 Amherst St
Winchester, VA 226012808
Phone: (540) 536-8000
Fax: (540) 536-7780
Type: Location
21909 N 120TH AVE
SUN CITY, AZ 853735672
Phone: (602) 549-3443
Fax: (623) 492-0390
Type: Mailing
111 COLCHESTER AVE
BURLINGTON, VT 054011473
Phone: (802) 847-0000
Type: Location
2315 STOCKTON BLVD
SACRAMENTO, CA 958172201
Phone: (916) 734-2011
Type: Location
Alzheimer’s Institute, 901, East Willetta Street, Central City, Phoenix, Maricopa County, Arizona, 85006, United States
STE. 2503
PHOENIX, AZ 850062727
Phone: (602) 239-5166
Fax: (602) 239-2307
Type: Location
8342, West Maya Drive, Peoria, Maricopa County, Arizona, 85383, United States
PEORIA, AZ 853833822
Phone: (623) 492-0390
Fax: (623) 492-0390
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $72.
Total Amount is formed as General ($72) + Research ($0) + Ownership ($0) = $72.
Last reported payment date: 2023-10-12 • Largest payer in this snapshot: AngioDynamics, Inc. ($72).
Total Amount
$72
General + Research + Ownership
Payments
1
Total payment records
General Amount
$72
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-10-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AngioDynamics, Inc. | $72 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-10-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160209001198 | I | Nurse Practitioner | VA | TBD |
| I20210819000966 | I | Nurse Practitioner | OH | TBD |
| I20220810002572 | I | Nurse Practitioner | VT | TBD |
| I20251021001872 | I | Nurse Practitioner | AZ | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 85006)
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