NPIMap

Individual provider Active NPI

Evan Gajkowski, CRNP

  • Nurse Practitioner
  • Danville, PA
National Provider Identifier
1538863329
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP027305 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-0001
Phone
(570) 214-1991
NPI assigned
Mar 28, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SP027305 PA
Nurse Practitioner 363L00000X SP027305 PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-0001

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230508001152 PA Practitioner - Nurse Practitioner 0840655262 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

255 Route 220 Hwy
Muncy, PA 17756-7569
Phone (570) 308-2600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP027305PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Nurse Practitioner CurrentSince Jun 18, 2023 Accepting new patients
Geisinger-HM Joint Venture, LLC Nurse Practitioner CurrentSince Jun 18, 2023 Accepting new patients
Geisinger Clinic CurrentSince Jun 18, 2023 Accepting new patients
Geisinger Clinic Nurse Practitioner Current Accepting new patients
Geisinger-HM Joint Venture, LLC Nurse Practitioner Current Accepting new patients
Geisinger-HM Joint Venture, LLC Nurse Practitioner CurrentSince Jun 18, 2023 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

6850 Lows Rd
Bloomsburg, PA 17815
Phone (570) 784-6243

4200 Hospital Rd
Coal Township, PA 17866
Phone (570) 644-4200

100 N Academy Ave
Danville, PA 17822

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

255 Route 220 Hwy
Ste 205
Muncy, PA 17756
Phone (570) 308-2445

255 Route 220 Hwy
Muncy, PA 17756
Phone (570) 308-2600

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300

Interoperability endpoints

  • Direct secure messaging: egajkowski564759@direct.geisinger.edu

Organizations & group practices 7

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 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1538863329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178220001",
            "telephone_number": "570-214-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAJKOWSKI",
        "first_name": "EVAN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP027305",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP027305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.