Individual provider Active NPI

Heather Gjertsen, FNP-BC

  • Nurse Practitioner
  • Monroe, NY
National Provider Identifier
1609689793
Registry record updated Feb 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F355912-01 Issued in NY
Practice address
1386 Lakes Rd
Monroe, NY 10950-4223
Phone
(845) 519-9183
NPI assigned
Jan 31, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F355912-01 NY Primary

Addresses

Primary practice location

1386 Lakes Rd
Monroe, NY 10950-4223

Mailing address

1386 Lakes Rd
Monroe, NY 10950-4223
Phone (845) 519-9183

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
I20250415001377 NY Practitioner - Nurse Practitioner 9830614684 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ion Oltean Physician PCGroup PAC ID 6406990860, 8 clinicians
Divinity Medical Services PLLCGroup PAC ID 5193030245, 92 clinicians

Practice addresses (Care Compare)

13966 35TH Ave
Flushing, NY 11354-3524
Phone (718) 961-5300

3379 Crompond Rd
Yorktown Heights, NY 10598-3605
Phone (914) 930-5550

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F355912-01NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ion Oltean Physician PC CurrentSince Jun 1, 2025 Accepting new patients
Divinity Medical Services PLLC CurrentSince Feb 7, 2025 Accepting new patients

Locations

22 Robert R Kasin Way
Beacon, NY 12508
Phone (845) 231-5792

332 E 149th St
Bronx, NY 10451
Phone (347) 329-4010

13966 35th Ave
Flushing, NY 11354
Phone (718) 961-5300

14702 34th Ave
Flushing, NY 11354
Phone (516) 682-5050

2 Glenmere Cove Rd
Goshen, NY 10924
Phone (845) 291-4700

46 Harriman Dr
Goshen, NY 10924
Phone (845) 291-3700

172 Meadow Hill Rd
Newburgh, NY 12550
Phone (410) 499-1437

1360 Route 112
Port Jefferson Station, NY 11776
Phone (631) 473-3304

37 S Mesier Ave
Wappingers Fl, NY 12590
Phone (718) 697-7523

3379 Crompond Rd
Yorktown Hts, NY 10598
Phone (914) 245-1111

Organizations & group practices 2

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 3

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": "1738281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738368000000",
    "number": "1609689793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1386 LAKES RD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109504223",
            "telephone_number": "845-519-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1386 LAKES RD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109504223",
            "telephone_number": "845-519-9183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GJERTSEN",
        "first_name": "HEATHER",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-31",
        "last_updated": "2025-02-01",
        "certification_date": "2025-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F355912-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NY

Sources for this page

Verify at the official NPI Registry.