Individual provider Active NPI

Gina Marie Kavanagh, AGACNP

  • Acute Care Nurse Practitioner
  • New York, NY
National Provider Identifier
1396231452
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
431320 Issued in NY
Practice address
1275 York Ave
New York, NY 10065-6007
Phone
(212) 639-2000
NPI assigned
Jul 2, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 431320 NY Primary
Acute Care Nurse Practitioner 363LA2100X 26NJ01073300 NJ

Addresses

Primary practice location

1275 York Ave
New York, NY 10065-6007

Mailing address

107 N Passaic Ave
Chatham, NJ 07928-2609
Phone (201) 230-7006

Other practice location 1

225 Summit Ave
Montvale, NJ 07645-1523
Phone (201) 775-7000

Other practice location 2

136 Mountainview Blvd
Basking Ridge, NJ 07920-3444
Phone (908) 466-5980

Other practice location 3

480 Red Hill Rd
Middletown, NJ 07748-3052
Phone (848) 800-5913

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181025001755 NY Practitioner - Nurse Practitioner 3274886924 Reassigns benefits to 2 organizations
I20210112000274 NJ Practitioner - Nurse Practitioner 3274886924 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MSK BergenGroup PAC ID 1456614114, 254 clinicians
MSK MonmouthGroup PAC ID 1153619291, 300 clinicians

Practice addresses (Care Compare)

136 Mountain View Blvd
Basking Ridge, NJ 07920-3444

136 Mountainview Blvd
Basking Ridge, NJ 07920-3444
Phone (908) 542-3000

225 Summit Ave
Montvale, NJ 07645-1523
Phone (908) 542-3336

480 Red Hill Rd
Middletown, NJ 07748-3052
Phone (908) 542-3007

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01073300NJMDAcute Care Nurse Practitioner
431320NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MSK Harrison CurrentSince Sep 8, 2025 Accepting new patients
Memorial Anesthesiology Group CurrentSince Sep 5, 2018 Accepting new patients

Locations

136 Mountainview Blvd
Basking Ridge, NJ 07920
Phone (908) 542-3000

480 Red Hill Rd
Middletown, NJ 07748
Phone (908) 542-3007

225 Summit Ave
Montvale, NJ 07645
Phone (908) 542-3336

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

500 Westchester Ave
West Harrison, NY 10604
Phone (914) 367-7000

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: gkavanagh36506@mskcc.direct-ci.com

Organizations & group practices 5

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 5

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": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1396231452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N PASSAIC AVE",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079282609",
            "telephone_number": "201-230-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Summit Ave",
            "address_purpose": "LOCATION",
            "city": "Montvale",
            "state": "NJ",
            "postal_code": "076451523",
            "country_code": "US",
            "telephone_number": "201-775-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "136 Mountainview Blvd",
            "address_purpose": "LOCATION",
            "city": "Basking Ridge",
            "state": "NJ",
            "postal_code": "079203444",
            "country_code": "US",
            "telephone_number": "908-466-5980",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "480 Red Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "NJ",
            "postal_code": "077483052",
            "country_code": "US",
            "telephone_number": "848-800-5913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAVANAGH",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "AGACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "431320",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ01073300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.