Individual provider Active NPI

Gabrielle Lillan Jorge, AGPCNP

  • Adult Health Nurse Practitioner
  • Rockville Centre, NY
National Provider Identifier
1154135168
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F312029-01 Issued in NY
Practice address
165 N Village Ave Ste 128
Rockville Centre, NY 11570-3763
Phone
(516) 764-2222
NPI assigned
Feb 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F312029-01 NY Primary

Addresses

Primary practice location

165 N Village Ave Ste 128
Rockville Centre, NY 11570-3763

Mailing address

165 N Village Ave Ste 128
Rockville Centre, NY 11570-3763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250804002778 NY Order and Referring Only - Nurse Practitioner 8820506504

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
312029NYMDLicensed Practical Nurse
F312029-01NYMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1154135168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 N VILLAGE AVE STE 128",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 N VILLAGE AVE STE 128",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703763",
            "telephone_number": "516-764-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGE",
        "first_name": "GABRIELLE",
        "middle_name": "LILLAN",
        "credential": "AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F312029-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

Verify at the official NPI Registry.