Individual provider Active NPI

Marshalette Stephanie Gillings, MSN, FNP-BC

  • Family Nurse Practitioner
  • Far Rockaway, NY
National Provider Identifier
1417370412
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
33 338471 Issued in NY
Practice address
327 Beach 19TH St
Far Rockaway, NY 11691-4423
Phone
(718) 869-7393
Fax
(718) 869-7806
NPI assigned
Jan 27, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 22 581165 NY
Family Nurse Practitioner 363LF0000X 33 338471 NY Primary

Addresses

Primary practice location

327 Beach 19TH St
Far Rockaway, NY 11691-4423

Mailing address

327 Beach 19TH St
Far Rockaway, NY 11691-4423
Phone (718) 869-7000

Other practice location 1

495 Beach 20th St
Far Rockaway, NY 11691-3621
Phone (347) 619-5950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20180419001219 NY Practitioner - Nurse Practitioner 9335402601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.83 of 100Reported as group
Quality
78.68
Promoting interoperability
98
Improvement activities
40
Cost
82.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
22 581165NYMDRegistered Nurse
33 338471NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Full Body Family Health NP, P.C. Registered Nurse Current Accepting new patients
St John'S Medical Services PC CurrentSince Apr 11, 2022 Accepting new patients
Episcopal Health Services Inc Past Accepting new patients

Locations

495 Beach 20th St
Far Rockaway, NY 11691
Phone (347) 619-5950

1909 Plainview Ave
Far Rockaway, NY 11691
Phone (718) 869-7690

327 Beach 19th St
Far Rockaway, NY 11691
Phone (718) 689-7640

Networks

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14448/brand/1/csg/1/fhir/r4
  • Direct secure messaging: marshalette.gillings.1@24989.direct.athenahealth.com
  • Direct secure messaging: marshalette.gillings.1@14448.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1417370412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 BEACH 19TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116914423",
            "telephone_number": "718-869-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 BEACH 19TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116914423",
            "telephone_number": "718-869-7393",
            "fax_number": "718-869-7806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "495 Beach 20th St",
            "address_purpose": "LOCATION",
            "city": "Far Rockaway",
            "state": "NY",
            "postal_code": "116913621",
            "country_code": "US",
            "telephone_number": "347-619-5950",
            "fax_number": "347-619-9053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLINGS",
        "first_name": "MARSHALETTE",
        "middle_name": "STEPHANIE",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-27",
        "last_updated": "2023-02-06",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "22 581165",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "33 338471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

Verify at the official NPI Registry.