Mary Judith Gardner, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

4704281984 Issued in MI

Practice address

519 Encinitas Blvd Ste 106
Encinitas, CA 92024-3738

Phone

(619) 703-7220

Fax

(619) 703-7221

NPI assigned

Apr 22, 2021

Last updated

Aug 18, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ronald Vanderlaan, MD, PLLCGroup PAC ID 0143304667, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
• Mercy Health Saint Mary's Hospital, Grand Rapids, MI, CCN 230059

Merit-based Incentive Payment System (MIPS)

Final score

90.52 of 100Reported as group

Quality

95.14

Promoting interoperability

100

Improvement activities

40

Cost

73.28

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgardner174945@epic00.corewelldirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ronald Vanderlaan, MD, PLLC

  dba Greater Cardiology

  • Cardiovascular Disease Physician
  • Grand Rapids, MI
  • NPI 1942482641
  Medicare reassignment Care Compare group NPD

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

• Pennock Hospital

  dba Corewell Health Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Saint Mary's Health Services

  dba Mercy Health Saint Mary's

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1639111057
  Care Compare affiliation
• Spectrum Health Hospitals

  dba Corewell Health Grand Rapids Hospital

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1033791843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3927 WARING RD STE C",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564458",
            "telephone_number": "619-703-7220",
            "fax_number": "619-703-7221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 ENCINITAS BLVD STE 106",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920243738",
            "telephone_number": "619-703-7220",
            "fax_number": "619-703-7221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "MARY",
        "middle_name": "JUDITH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704281984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie A Gan, DDS
• Su Gao, DDS
• Alexandra Garcia, PHARM. D.
• Caroline Marie Garcia
• Rosemarie Garcia, LMFT
• Garfield Beach CVS LLC (CVS Pharmacy #16416)
• Garfield Beach CVS LLC (CVS Pharmacy #09181)
• Laura Garfine, FNP-C
• Vikram Kumar Garg, MD
• Randy William Garland, DDS

• Gerontology Nurse Practitioner in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.