KATHRYN JANE GORAB (PA) – Physician Assistant, NPI 1114701414

KATHRYN JANE GORAB (PA) is a healthcare provider. based in Albuquerque, New Mexico. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. The NPI Number for KATHRYN JANE GORAB (PA) is 1114701414

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
KATHRYN JANE GORAB (PA)
NPI
1114701414
Phone
Not provided
Address
1500 N RENAISSANCE BLVD NE STE C
Enumeration Date
21 August 2023
Last Update Date
17 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5058141995
Graduation Year
2025 (1 year ago)
PAC ID
1658862982
Group Practice PAC ID
3173848058
Professional Enrollment ID
I20251114002271
Address ID
NM871112660AL11601NEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness85
Years active:2State licenses:0Digital endpointsOther names

896 PHYSICIAN ASSISTANT in NM

Provider Addresses for KATHRYN JANE GORAB (PA)

  • 1500 N RENAISSANCE BLVD NE STE C

    ALBUQUERQUE, NM 871077002

    Phone:

    Type: Mailing

  • 11601 MONTGOMERY BLVD NE

    ALBUQUERQUE, NM 871112660

    Phone: (505) 418-8900

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-11-14

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251114002271IPhysician AssistantNMTBD

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.

Verify on CMS Revalidation Lookup Tool

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 87107)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3173848058View full group profile

Reviews

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Frequently asked questions

What NPI should I save for KATHRYN JANE GORAB (PA)?
Save NPI 1114701414 if you need a stable reference for KATHRYN JANE GORAB (PA).
Is KATHRYN JANE GORAB (PA)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does KATHRYN JANE GORAB (PA) work in?
You can think of KATHRYN JANE GORAB (PA) as practicing within Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is KATHRYN JANE GORAB (PA)'s primary listing?
We display Albuquerque, New Mexico because that is what the record indicates for KATHRYN JANE GORAB (PA).
Is KATHRYN JANE GORAB (PA) a real provider?
This page reflects official NPPES data for NPI 1114701414. Always confirm identity and privileges with the practice and licensing boards.

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