Individual provider Active NPI

Stefan Adrian Gillen, DO

  • Epilepsy Physician
  • Pompton Plains, NJ
National Provider Identifier
1003302670
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Epilepsy PhysicianTaxonomy code 2084E0001X
License
25MB11831000 Issued in NJ
Practice address
242 W Parkway
Pompton Plains, NJ 07444-1029
Phone
(862) 248-8100
Fax
(862) 248-8166
NPI assigned
Jul 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 25MB11831000 NJ
Epilepsy Physician 2084E0001X 25MB11831000 NJ Primary

Addresses

Primary practice location

242 W Parkway
Pompton Plains, NJ 07444-1029

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
I20231204003645 NJ Practitioner - Neurology 2365827615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Rowan University School of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

175 High St
Newton, NJ 07860-1004
Phone (973) 383-2121

651 Willow Grove St
Hackettstown, NJ 07840-1799
Phone (908) 441-1161

97 W Pkwy
Pompton Plains, NJ 07444-1647
Phone (973) 931-5000

Hospital & facility affiliations

  • Morristown Medical Center Hospital, Morristown, NJ, CCN 310015
  • Overlook Medical Center Hospital, Summit, NJ, CCN 310051
  • Chilton Medical Center Hospital, Pompton Plains, NJ, CCN 310017
  • Newton Medical Center Hospital, Newton, NJ, CCN 310028
  • Ahs Hospital Corp Hospital, Hackettstown, NJ, CCN 310115

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19587CAMDEmergency Medicine Physician
25MB11831000NJMDEpilepsy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group CurrentSince Oct 3, 2023 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

242 W Parkway
Ste 101
Pompton Plains, NJ 07444

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 5

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": "1530921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1003302670",
    "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": "242 W PARKWAY",
            "city": "POMPTON PLAINS",
            "state": "NJ",
            "postal_code": "074441029",
            "telephone_number": "862-248-8100",
            "fax_number": "862-248-8166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLEN",
        "first_name": "STEFAN",
        "middle_name": "ADRIAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-07",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MB11831000",
            "primary": false
        },
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "NJ",
            "license": "25MB11831000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompton Plains, NJ

Sources for this page

Verify at the official NPI Registry.