Individual provider Active NPI

Lizkebe Gado, NP

  • Primary Care Nurse Practitioner
  • Penns Grove, NJ
National Provider Identifier
1053207522
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
SP032591 Issued in PA
Practice address
362 Annabelle Ave
Penns Grove, NJ 08069-2621
Phone
(803) 728-7824
NPI assigned
Jun 13, 2025
Last updated
Jun 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X SP032591 PA Primary
Primary Care Nurse Practitioner 363LP2300X 312817 NY

Addresses

Primary practice location

362 Annabelle Ave
Penns Grove, NJ 08069-2621

Mailing address

362 Annabelle Ave
Penns Grove, NJ 08069-2621
Phone (803) 728-7824

Other practice location 1

161 Cecil B Moore Ave Apt 204
Philadelphia, PA 19122-3243
Phone (866) 306-2026

Other practice location 2

18 E 41st St Fl 14
New York, NY 10017-6244
Phone (215) 585-2144

Other practice location 3

527 Bay Rd Ste 7
Queensbury, NY 12804-1430
Phone (215) 585-2144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 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
I20250701000355 PA Practitioner - Nurse Practitioner 3678086915 Reassigns benefits to 1 organization
I20260604002242 NY Practitioner - Nurse Practitioner 3678086915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ophelia Medical Group FL PAGroup PAC ID 7810398534, 103 clinicians

Practice addresses (Care Compare)

161 Cecil B Moore Ave
Apt 204
Philadelphia, PA 19122-3243
Phone (215) 585-2144

18 E 41St St
FL 14
New York, NY 10017-6244
Phone (215) 585-2144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
312817NYMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ophelia Medical Group, P.C. CurrentSince Jun 23, 2025 Accepting new patients
Ophelia Medical Group FL, P.a. CurrentSince Jun 23, 2025 Accepting new patients

Locations

18 E 41st St
Fl 14
New York, NY 10017
Phone (305) 395-4313

228 Park Ave S
New York, NY 10003
Phone (215) 588-2144

527 Bay Rd
Ste 7
Queensbury, NY 12804
Phone (212) 585-2144

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1749772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1053207522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 ANNABELLE AVE",
            "city": "PENNS GROVE",
            "state": "NJ",
            "postal_code": "080692621",
            "telephone_number": "803-728-7824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "362 ANNABELLE AVE",
            "city": "PENNS GROVE",
            "state": "NJ",
            "postal_code": "080692621",
            "telephone_number": "803-728-7824"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 Cecil B Moore Ave Apt 204",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191223243",
            "country_code": "US",
            "telephone_number": "866-306-2026",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18 E 41st St Fl 14",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100176244",
            "country_code": "US",
            "telephone_number": "215-585-2144",
            "fax_number": "833-228-5591",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "527 Bay Rd Ste 7",
            "address_purpose": "LOCATION",
            "city": "Queensbury",
            "state": "NY",
            "postal_code": "128041430",
            "country_code": "US",
            "telephone_number": "215-585-2144",
            "fax_number": "833-228-5591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GADO",
        "first_name": "LIZKEBE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-13",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP032591",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "312817",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Penns Grove, NJ

Sources for this page

Verify at the official NPI Registry.