STORMIE RAE GOUGH DO
NPI 1164045209
Pediatrics in Allentown, PA
About Stormie Rae Gough Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STORMIE RAE GOUGH DO (NPI 1164045209) is an individual pediatrics provider in Allentown, Pennsylvania, licensed in Pennsylvania (OS022997) and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Stormie Rae Gough Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Stormie Gough reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Reading, PA 19604
- Reassigned Medicare billing, Pennsylvania enrollment
- 251 clinicians in this Medicare group
Reading, PA 19605
- Reassigned Medicare billing, Pennsylvania enrollment
- 994 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 18103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ALLENTOWN, PA 18103
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Stormie Gough's NPI number?
The NPI number for Stormie Gough is 1164045209. It was assigned to this individual provider in the NPPES registry on May 23, 2020. The provider is also known as Stormie Rae Wagner.
Where is Stormie Gough located?
Stormie Gough practices at 1200 S Cedar Crest Blvd Fl 6, Allentown, PA 18103. The listed phone number is (610) 402-7712.
What is Stormie Gough's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Stormie Gough enrolled in Medicare?
Yes. Stormie Gough is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Stormie Gough's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Stormie Gough reassigns Medicare benefits to 2 organizations: St. Joseph Medical Group (Reading, PA) and Penn State Health Medical Group, LLC (Reading, PA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Stormie Gough's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Stormie Gough was last updated on August 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Stormie Rae Gough, DO · NPI 1164045209
Pediatrics physician in Allentown, Pennsylvania. Individual provider, active in the CMS NPPES registry since May 23, 2020.
## Identity
- **NPI:** 1164045209 (Entity type: Individual)
- **Enumerated:** May 23, 2020
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** OS022997 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 1200 S CEDAR CREST BLVD FL 6, Allentown, PA 18103-6202
- **Phone:** (610) 402-7712
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): St. Joseph Medical Group (NPI 1750590881, Reading, PA); Penn State Health Medical Group, LLC (NPI 1942955521, Reading, PA) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 10, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1164045209) · Data from the CMS NPPES public registry.