Individual provider Active NPI

Gina Ferraro Mormino, NNP

  • Neonatal Nurse Practitioner
  • Hackensack, NJ
National Provider Identifier
1669712592
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
26NJ00621400 Issued in NJ
Practice address
30 Prospect Ave BLDG Pc218
Hackensack, NJ 07601-1915
Phone
(551) 996-5362
Fax
(551) 996-3232
NPI assigned
Mar 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X F350350 NY
Neonatal Nurse Practitioner 363LN0000X 26NJ00621400 NJ Primary

Addresses

Primary practice location

30 Prospect Ave BLDG Pc218
Hackensack, NJ 07601-1915

Mailing address

30 Prospect Ave BLDG Pc218
Hackensack, NJ 07601-1915
Phone (551) 996-5362

Other practice location 1

455 Conklintown Rd
Ringwood, NJ 07456-2603
Phone (201) 739-3484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160916000068 NJ Practitioner - Nurse Practitioner 9537455605 Reassigns benefits to 2 organizations
I20200508000050 NY Practitioner - Nurse Practitioner 9537455605 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F350350NYMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Mar 1, 2020 Accepting new patients
Valley Physician Services PC CurrentSince Mar 1, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Nov 22, 2022 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Nov 22, 2022 Accepting new patients
Humc Medical Observation Past Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC PastSince Oct 30, 2022 Accepting new patients

Locations

30 Prospect Ave
Bldg PC218
Hackensack, NJ 07601
Phone (551) 996-5362

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

300 Community Dr
Plandome, NY 11030

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 6

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": "1362096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1669712592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE BLDG PC218",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-5362",
            "fax_number": "551-996-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE BLDG PC218",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-5362",
            "fax_number": "551-996-3232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 Conklintown Rd",
            "address_purpose": "LOCATION",
            "city": "Ringwood",
            "state": "NJ",
            "postal_code": "074562603",
            "country_code": "US",
            "telephone_number": "201-739-3484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERRARO MORMINO",
        "first_name": "GINA",
        "name_prefix": "Mrs.",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-01",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "NY",
            "license": "F350350",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "NJ",
            "license": "26NJ00621400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.