Individual provider Active NPI

Gabriella Hope Medina

  • Surgical Physician Assistant
  • New Brunswick, NJ
National Provider Identifier
1164298014
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00816000 Issued in NJ
Practice address
1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928
Phone
(732) 828-3000
NPI assigned
Dec 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X 25MP00816000 NJ
Physician Assistant 363A00000X
Surgical Physician Assistant 363AS0400X 25MP00816000 NJ Primary

Addresses

Primary practice location

1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928

Mailing address

168 Hawkin Rd
New Egypt, NJ 08533-2802
Phone (609) 752-4346

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
I20240822003384 NJ Practitioner - Physician Assistant 1254870132 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rutgers Health-RWJ Neurosurgery FacultyGroup PAC ID 4587613443, 189 clinicians

Practice addresses (Care Compare)

1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928

110 Rehill Ave
Somerville, NJ 08876-2519
Phone (908) 203-6247

125 Paterson St
New Brunswick, NJ 08901-1962

Rutgers Health-RWJ Neurosurgery
Suite 2200
New Brunswick, NJ 08901-1928
Phone (732) 828-3000

Hospital & facility affiliations

  • Robert Wood Johnson University Hospital Hospital, New Brunswick, NJ, CCN 310038
  • Community Medical Center Hospital, Toms River, NJ, CCN 310041

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Jan 1, 2024 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty Multi-Specialty CurrentSince Jan 1, 2024 Accepting new patients

Locations

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

125 Paterson St
Ste 4100
New Brunswick, NJ 08901
Phone (732) 235-7756

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

Organizations & group practices 4

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 2

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": "1701388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1164298014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 HAWKIN RD",
            "city": "NEW EGYPT",
            "state": "NJ",
            "postal_code": "085332802",
            "telephone_number": "609-752-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ROBERT WOOD JOHNSON PL",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011928",
            "telephone_number": "732-828-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "GABRIELLA",
        "middle_name": "HOPE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-01",
        "last_updated": "2024-07-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MP00816000",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00816000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.