Individual provider Active NPI

Kajal Gandhi, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Old Bridge, NJ
National Provider Identifier
1144705328
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00862900 Issued in NJ
Practice address
200 Perrine Rd
Old Bridge, NJ 08857-2842
Phone
(732) 264-1163
NPI assigned
Oct 3, 2018
Last updated
Oct 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00862900 NJ Primary

Addresses

Primary practice location

200 Perrine Rd
Old Bridge, NJ 08857-2842

Mailing address

200 Perrine Rd
Old Bridge, NJ 08857-2842
Phone (732) 264-1163

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250226001616 NJ Practitioner - Nurse Practitioner 8921528506 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
GK Health, PC CurrentSince Dec 13, 2024 Accepting new patients

Locations

670 N Beers St
Ste 1
Holmdel, NJ 07733
Phone (732) 226-5552

100 Main St
Keansburg, NJ 07734
Phone (732) 264-1163

200 Perrine Rd
Ste 221
Old Bridge, NJ 08857
Phone (732) 264-1163

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, 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": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1144705328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PERRINE RD",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572842",
            "telephone_number": "732-264-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PERRINE RD",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572842",
            "telephone_number": "732-264-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDHI",
        "first_name": "KAJAL",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2024-10-15",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00862900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

Verify at the official NPI Registry.