Individual provider Active NPI

Jillian A Garbutt, PA

  • Physician Assistant
  • Somers Point, NJ
National Provider Identifier
1285075374
Registry record updated Feb 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00311000 Issued in NJ
Practice address
100 Medical Center Way
Somers Point, NJ 08244-2300
Phone
(609) 653-3500
NPI assigned
Jul 17, 2013
Last updated
Feb 10, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00311000 NJ Primary

Addresses

Primary practice location

100 Medical Center Way
Somers Point, NJ 08244-2300

Mailing address

100 Medical Center Way
Somers Point, NJ 08244-2300
Phone (609) 653-3500

Other identifiers 1

IdentifierTypeStateIssuer
25MP00311000OtherNJLICENSE

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
I20131010001548 NJ Practitioner - Physician Assistant 4688808413 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cape Regional Urgent Care LLCGroup PAC ID 5395861728, 36 clinicians

Practice addresses (Care Compare)

11 Court House S Dennis Rd
Suite 3
Cape May Court House, NJ 08210

11 Court House S Dennis Rd
Suite 3
Cape May Court House, NJ 08210-2150
Phone (609) 465-6364

406 W Rio Grande Ave
Wildwood, NJ 08260-1524
Phone (609) 465-6364

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00311000NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Regional Urgent Care LLC CurrentSince May 6, 2014 Accepting new patients
Main Line Emergency Med Associates LLC Past Accepting new patients

Locations

11 Court House South Dennis Rd
Ste 3
Cape May Court House, NJ 08210
Phone (609) 465-6364

406 W Rio Grande Ave
Wildwood, NJ 08260
Phone (609) 465-6364

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, 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": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423526400000",
    "number": "1285075374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER WAY",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "082442300",
            "telephone_number": "609-653-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER WAY",
            "city": "SOMERS POINT",
            "state": "NJ",
            "postal_code": "082442300",
            "telephone_number": "609-653-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARBUTT",
        "first_name": "JILLIAN",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2015-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00311000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "25MP00311000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somers Point, NJ

Sources for this page

Verify at the official NPI Registry.