Nelly Gavalakis, APN-C

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

20050002 Issued in NJ

Practice address

155 Polifly Rd Ste 112
Hackensack, NJ 07601-1749

Phone

(201) 996-8840

Fax

(201) 441-9949

NPI assigned

May 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nelly.gavalakis@direct.hackensackmeridian.org
• FHIR API: https://api.platform.athenahealth.com/5610/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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.

• Hackensack Meridian Health Medical Group - Complex Care PC

  • Internal Medicine Physician
  • Red Bank, NJ
  • NPI 1154379626
  Medicare reassignment NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Surgical Critical Care Physician
  • Red Bank, NJ
  • NPI 1215989249
  Medicare reassignment NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Durable Medical Equipment & Medical Supplies
  • North Bergen, NJ
  • NPI 1215734199
  NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Psychologist
  • Red Bank, NJ
  • NPI 1609593722
  NPD (past)
• French Broad Pediatric Associates, PLLC

  • Pediatrics Physician
  • Asheville, NC
  • NPI 1245587534
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1174577746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 RAINBOW TER",
            "city": "BLACK MOUNTAIN",
            "state": "NC",
            "postal_code": "287118439",
            "telephone_number": "917-757-7261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 POLIFLY RD STE 112",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011749",
            "telephone_number": "201-996-8840",
            "fax_number": "201-441-9949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 N Merrimon Ave Ste 117",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288041368",
            "country_code": "US",
            "telephone_number": "828-348-8232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAVALAKIS",
        "first_name": "NELLY",
        "credential": "APN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5021153",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "20050002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Favorite M Garfinkel
• Edwin Jeffrey Garino, DDS
• Gary D. Schwartz, MD PC
• Luningning Castro Gatchalian, MD
• Sandra Lee Gauker, RN, APN, C.
• Irina Gavdanovich, FNP
• Noha Gayed, MD
• Lauren Stacy Gayoso-Acuna
• Helen Negash Gebre
• Kerry Geddis

• Pediatric Nurse Practitioner in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Pediatric Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.