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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KATHERINE GAVAGAN MD
NPI 1750220224
Student in an Organized Health Care Education/Training Program in Port Huron, MI

Active since March 27, 2026PECOS Enrolled
1216 RICHARDSON ST, PORT HURON, MI 48060(810) 985-2640(810) 962-8294 Get Directions Write a Review

NPPES record last updated: June 30, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Katherine Gavagan Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHERINE GAVAGAN MD (NPI 1750220224) is an individual student in an organized health care education/training program in Port Huron, Michigan and active in the NPI registry since March 2026. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1750220224
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameKATHERINE GAVAGANCredential: MD
Location Address1216 RICHARDSON STPort Huron, MI 48060-3549
Mailing Address1265 Beaconsfield AveGrosse Pointe Park, MI 48230-1056 · (313) 610-0106
Phone(810) 985-2640
Fax(810) 962-8294
Sole ProprietorNo
Enumeration DateMarch 27, 2026
Last NPPES UpdateJune 30, 2026
NPPES CertifiedJune 30, 2026
✔ NPI 1750220224 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1216 RICHARDSON ST, Port Huron, MI 48060
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Katherine Gavagan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SARA E LITER-KUESTER DO
Internal Medicine
1216 RICHARDSON ST
PORT HURON, MI 48060
St. Clair County (810) 985-2640
MAXWELL BROWN
Student in an Organized Health Care Education/Training Program
1216 RICHARDSON ST
PORT HURON, MI 48060
St. Clair County (810) 985-2640
MEHMET ISMAILOGLU MD
Student in an Organized Health Care Education/Training Program
1216 RICHARDSON ST
PORT HURON, MI 48060
St. Clair County (810) 985-2640
ADITI KUKREJA DO
Student in an Organized Health Care Education/Training Program
1216 RICHARDSON ST
PORT HURON, MI 48060
St. Clair County (810) 985-2640
JESSICA ANN JORGE MD
Student in an Organized Health Care Education/Training Program
1216 RICHARDSON ST
PORT HURON, MI 48060
St. Clair County (810) 985-2640
ASSOCIATES FOR INTERNAL MEDICINE, P.C.
Internal Medicine
1216 RICHARDSON ST
PORT HURON, MI 48060
St. Clair County (810) 985-6777
RICHARD J HEGLUND MD
Family Medicine
1216 RICHARDSON ST
PORT HURON, MI 48060
St. Clair County (810) 985-2620
NEHA UPPAL MD
Student in an Organized Health Care Education/Training Program
1216 RICHARDSON ST
PORT HURON, MI 48060
St. Clair County (810) 985-2640

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 Katherine Gavagan's NPI number?

The NPI number for Katherine Gavagan is 1750220224. It was assigned to this individual provider in the NPPES registry on March 27, 2026.

Where is Katherine Gavagan located?

Katherine Gavagan practices at 1216 Richardson St, Port Huron, MI 48060. The listed phone number is (810) 985-2640.

What is Katherine Gavagan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Katherine Gavagan enrolled in Medicare?

Yes. Katherine Gavagan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Katherine Gavagan was last updated on June 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 51 days 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.