Individual provider Active NPI

Jill S Gallagher

  • Gerontology Nurse Practitioner
  • Boonton, NJ
National Provider Identifier
1215000856
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
26NN09522900 Issued in NJ
Practice address
223 W Main St Ste 3
Boonton, NJ 07005-1165
Phone
(973) 335-8656
Fax
(973) 335-8986
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NN009522900 NJ
Gerontology Nurse Practitioner 363LG0600X 26NN09522900 NJ Primary

Addresses

Primary practice location

223 W Main St Ste 3
Boonton, NJ 07005-1165

Mailing address

PO Box 95000, LB#7550
Philadelphia, PA 19195-7550
Phone (844) 362-1735

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
I20060316000139 NJ Practitioner - Nurse Practitioner 3072520063 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care Partners LLCGroup PAC ID 2860665809, 74 clinicians

Practice addresses (Care Compare)

Little Falls, NJ 07424
Phone (973) 335-8656

223 W Main St
Suite 3
Boonton, NJ 07005-1166
Phone (973) 335-8656

Hospital & facility affiliations

  • Morristown Medical Center Hospital, Morristown, NJ, CCN 310015
  • Saint Clare'S Hospital/ Denville Campus Hospital, Denville, NJ, CCN 310050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NN009522900NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Partners, LLC CurrentSince Jun 1, 2024 Accepting new patients
Practice Associates Medical Group CurrentSince Apr 1, 2012 Accepting new patients
Fellowship Senior Living, Inc. CurrentSince Nov 1, 2020 Accepting new patients
Primary Care Partners, LLC CurrentSince Jun 1, 2024 Accepting new patients
Fellowship Village Inc. CurrentSince Nov 1, 2020 Accepting new patients
Salem Medical Services LLC CurrentSince Feb 2, 2025 Accepting new patients
Primary Care Partners, LLC Nurse Practitioner Current Accepting new patients
Vital Medical Forces of Dover PC Past Accepting new patients
Primary Care Partners LLC Past Accepting new patients

Locations

8000 Fellowship Rd
Basking Ridge, NJ 07920
Phone (908) 580-3800

223 W Main St
Ste 3
Boonton, NJ 07005
Phone (973) 335-8656

223 W Main St
Boonton, NJ 07005
Phone (973) 263-2080

25 Pocono Rd
Denville, NJ 07834
Phone (273) 625-6000

16 Pocono Rd
Ste 305
Denville, NJ 07834
Phone (973) 627-0484

475 South St
Morristown, NJ 07960
Phone (973) 660-3166

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19916/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jgallagher18388@direct.ahsys.org

Organizations & group practices 9

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1215000856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000, LB#7550",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191957550",
            "telephone_number": "844-362-1735",
            "fax_number": "973-290-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 W MAIN ST STE 3",
            "city": "BOONTON",
            "state": "NJ",
            "postal_code": "070051165",
            "telephone_number": "973-335-8656",
            "fax_number": "973-335-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "JILL",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NN009522900",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NN09522900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boonton, NJ

Sources for this page

Verify at the official NPI Registry.