Gina Marie Theofanidis, APN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

26NJ00954100 Issued in NJ

Practice address

511 Courtyard Dr BLDG 500
Hillsborough, NJ 08844-4255

Phone

(908) 218-9222

Fax

(908) 218-1078

NPI assigned

Aug 28, 2019

Last updated

Aug 28, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Morristown Medical Center Hospital, Morristown, NJ, CCN 310015

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gtheofanidis58087@epicdirect.rwjbh.org

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.

• Practice Associates Medical Group

  dba Atlantic Medical Group

  • Internal Medicine Physician
  • Morristown, NJ
  • NPI 1427016385
  Medicare reassignment Care Compare group NPD
• Digestive Healthcare Center PA

  • Specialist
  • Hillsborough, NJ
  • NPI 1255318085
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahs Hospital Corp.

  dba Morristown Medical Center

  • General Acute Care Hospital
  • Morristown, NJ
  • NPI 1053384776
  Care Compare affiliation

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1336797851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 COURTYARD DR BLDG 500",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088444255",
            "telephone_number": "908-218-9222",
            "fax_number": "908-218-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 COURTYARD DR BLDG 500",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088444255",
            "telephone_number": "908-218-9222",
            "fax_number": "908-218-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEOFANIDIS",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00954100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Awareness Practice LLC
• The Devereux Foundation (Devereux Advanced Behavioral Health)
• The Devereux Foundation (Devereux Advanced Behavioral Health)
• The Devereux Foundation (Devereux Advanced Behavioral Health)
• The Sleep Medicine Center, P.C. (Total Lung Care)
• Therapy to Go
• Alba Lucia Thomas, MS, CLC
• Thrive Physical Therapy & Rehab
• Neng Tian, MASSAGE THERAPIST
• Joyce Tiemens, LCSW

• Gerontology Nurse Practitioner in Hillsborough, NJ
• Providers in Hillsborough, NJ by specialty
• Gerontology Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.