Elizabeth Sgambelluri, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00666600 Issued in NJ

Practice address

1005 N Washington Ave
Green Brook, NJ 08812-2698

Phone

(732) 968-8900

NPI assigned

Oct 5, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1639841935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 LOCUST DR APT 17",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079014420",
            "telephone_number": "484-553-3085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 N WASHINGTON AVE",
            "city": "GREEN BROOK",
            "state": "NJ",
            "postal_code": "088122698",
            "telephone_number": "732-968-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SGAMBELLURI",
        "first_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-05",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "1187799",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00666600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald M Frank, Mdpa
• Jeffrey James Ruffo, OD
• Pamela A Saus, O.D.
• Shannon Schnepf, PA-C
• Carol E Sgambelluri, MD
• Pinal Shah, PHARM. D.
• Yoram Sharon, DO
• Keron A Sinclair, PAC
• Leonard Siskin, D.C.
• State of New Jersey Omb Centralized Payroll

• Physician Assistant in Green Brook, NJ
• Providers in Green Brook, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.