Gabrielle Gannon

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

031131 Issued in NY

Practice address

2960 Victory Blvd
Staten Island, NY 10314-6605

Phone

(718) 370-2014

NPI assigned

Apr 19, 2023

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

Other names 1

• Gabrielle Fliorent Former name

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Excel Urgent Care of Wantagh PLLCGroup PAC ID 9234364027, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Excel Urgent Care of Wantagh PLLC

  • Urgent Care Clinic/Center
  • Wantagh, NY
  • NPI 1184067936
  Medicare reassignment Care Compare group
• Mark E Pruzansky MD PC

  • Medical Specialty Clinic/Center
  • New York, NY
  • NPI 1922270883
  NPD (past)

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

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1669169835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 TEMPLE HILL RD STE 102",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125535529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146605",
            "telephone_number": "718-370-2014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3894 Richmond Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103125111",
            "country_code": "US",
            "telephone_number": "347-630-7985",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7001 Amboy Rd",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103071444",
            "country_code": "US",
            "telephone_number": "347-838-6991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANNON",
        "first_name": "GABRIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-19",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "031131",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00826400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GABRIELLE",
            "last_name": "FLIORENT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Diana Gangal
• Lisa Marie Gangemi, MS, RDN
• Tommi-Ann Gangi
• Trystan Gangi
• Aziz Ganiev, RN
• Jacqueline Gannon, CF
• Kerrianna Ganpath
• Resha Reya Ganthan, MD
• Rosalba Gaona Cadena, 771235
• Gayathri Gara, M.D

• Physician Assistant in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.