Individual provider Active NPI

Anita Gill, M.D.

  • Neurology Physician
  • Summit, NJ
National Provider Identifier
1003003070
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
25MA11527300 Issued in NJ
Practice address
11 Overlook Rd Ste B110
Summit, NJ 07901-3577
Phone
(908) 522-2709
Fax
(908) 522-6123
NPI assigned
Oct 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 246379 NY
Clinical Neurophysiology Physician 2084N0600X 246379 NY
Neurology Physician 2084N0400X 25MA11527300 NJ Primary

Addresses

Primary practice location

11 Overlook Rd Ste B110
Summit, NJ 07901-3577

Mailing address

PO Box 416457
Boston, MA 02241-6457
Phone (844) 362-1735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221215001015 NJ Practitioner - Neurology 7012089626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

11 Overlook Rd
Summit, NJ 07901-3577
Phone (908) 273-1493

Hospital & facility affiliations

  • Overlook Medical Center Hospital, Summit, NJ, CCN 310051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
246379NYMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group CurrentSince Nov 28, 2022 Accepting new patients

Locations

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

11 Overlook Rd
Summit, NJ 07901
Phone (908) 273-1493

11 Overlook Rd
Ste B110
Summit, NJ 07901
Phone (908) 522-2709

99 Beauvoir Ave
Fl 5
Summit, NJ 07901
Phone (908) 522-2829

Interoperability endpoints

  • Direct secure messaging: anita.gill.1@8502.direct.athenahealth.com
  • FHIR API: https://call.api.northwell.io/epic-proxy/api/fhir/R4/

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1003003070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457",
            "telephone_number": "844-362-1735",
            "fax_number": "973-290-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 OVERLOOK RD STE B110",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013577",
            "telephone_number": "908-522-2709",
            "fax_number": "908-522-6123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "ANITA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-03",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "246379",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NY",
            "license": "246379",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MA11527300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

Verify at the official NPI Registry.