NPIMap

Individual provider Active NPI

Gbemisola J Alli, APN

  • Primary Care Nurse Practitioner
  • Short Hills, NJ
National Provider Identifier
1336667237
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
26NJ00743800 Issued in NJ
Practice address
85 Woodland Rd
Short Hills, NJ 07078-2449
Phone
(973) 379-4496
Fax
(973) 376-0357
NPI assigned
Aug 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 26NJ00743800 NJ Primary

Addresses

Primary practice location

85 Woodland Rd
Short Hills, NJ 07078-2449

Mailing address

21 Edgewood Road
Summit, NJ 07901
Phone (973) 395-1550

Other practice location 1

60 Evergreen Place
Suite 400
East Orange, NJ 07018
Phone (973) 395-1550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171018000163 NJ Practitioner - Nurse Practitioner 8224304357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Hospital & facility affiliations

  • Kessler Rehab Center Inpatient rehabilitation facility, West Orange, NJ, CCN 313025

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Jul 26, 2021 Accepting new patients
Summit Medical Group PA CurrentSince Jul 26, 2021 Accepting new patients
Summit Medical Group, Inc PastSince Aug 29, 2021 Accepting new patients
The Heart Center of the Oranges Past Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

150 Floral Ave
New Providence, NJ 07974
Phone (908) 588-3890

Interoperability endpoints

  • Direct secure messaging: gbemisola.alli.1@2983.direct.athenahealth.com

Organizations & group practices 26

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.

View all 26

Hospital & facility affiliations 1

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": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1336667237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 EDGEWOOD ROAD",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "07901",
            "telephone_number": "973-395-1550",
            "fax_number": "973-395-1556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 WOODLAND RD",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070782449",
            "telephone_number": "973-379-4496",
            "fax_number": "973-376-0357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Evergreen Place",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "East Orange",
            "state": "NJ",
            "postal_code": "07018",
            "country_code": "US",
            "telephone_number": "973-395-1550",
            "fax_number": "973-395-1556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLI",
        "first_name": "GBEMISOLA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ00743800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Short Hills, NJ

Sources for this page

Verify at the official NPI Registry.