Individual provider Active NPI

Wesley Gingerella, PA-C

  • Surgical Physician Assistant
  • Florham Park, NJ
National Provider Identifier
1043816770
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00715700 Issued in NJ
Practice address
140 Park Ave
Florham Park, NJ 07932-1049
Phone
(973) 404-9800
Fax
(973) 267-1737
NPI assigned
Dec 8, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Surgical Physician Assistant 363AS0400X 5237 CT
Surgical Physician Assistant 363AS0400X 25MP00715700 NJ Primary

Addresses

Primary practice location

140 Park Ave
Florham Park, NJ 07932-1049

Mailing address

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220316001664 CT Practitioner - Physician Assistant 7517351638 Reassigns benefits to 1 organization
I20221025002451 NJ Practitioner - Physician Assistant 7517351638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
026354NYMDOccupational Therapist
5237CTMDSurgical Physician Assistant
25MP00715700NJMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Feb 2, 2022 Accepting new patients
Summit Medical Group PA CurrentSince Sep 12, 2022 Accepting new patients
Summit Medical Group PA CurrentSince Sep 12, 2022 Accepting new patients
Yale University CurrentSince Feb 2, 2022 Accepting new patients
Summit Medical Group, Inc Physician Assistant Past Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

140 Park Ave
Florham Park, NJ 07932
Phone (973) 285-7613

Interoperability endpoints

  • Direct secure messaging: wesley.gingerella.1@2983.direct.athenahealth.com
  • Direct secure messaging: gwesley1046545@nychhc.direct-ci.com

Organizations & group practices 5

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": "1607385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1043816770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-273-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 PARK AVE",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321049",
            "telephone_number": "973-404-9800",
            "fax_number": "973-267-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINGERELLA",
        "first_name": "WESLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-08",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "5237",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00715700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florham Park, NJ

Sources for this page

Verify at the official NPI Registry.