Ericka Deadwyler-Gourgue, NURSE PRACTITIONER

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

308867 Issued in NY

Practice address

571 E 19TH St Apt 6B
Brooklyn, NY 11226-7674

Phone

(929) 378-0430

NPI assigned

Aug 15, 2018

Last updated

Mar 12, 2025By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mindful Care NP in Psychiatry and NP in Adult Health PC

  • Adult Health Nurse Practitioner
  • Brooklyn, NY
  • NPI 1174380141
  Medicare reassignment Authorized official
• Queens Psychiatric & Medical Care P.C.

  • Psychiatry Physician
  • Rego Park, NY
  • NPI 1497119846

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Weill Medical College of Cornell

  • Internal Medicine Physician
  • New York, NY
  • NPI 1124170212
  Medicare reassignment NPD
• Weill Medical College of Cornell

  • Cardiovascular Disease Physician
  • New York, NY
  • NPI 1144729385
  NPD
• Weill Medical College of Cornell

  dba Cornell Dept. of Neurosurgery

  • Neurological Surgery Physician
  • New York, NY
  • NPI 1326088675
  NPD

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1689154130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 E 19TH ST APT 6B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112267674",
            "telephone_number": "929-378-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 E 19TH ST APT 6B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112267674",
            "telephone_number": "929-378-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEADWYLER-GOURGUE",
        "first_name": "ERICKA",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "308867",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F405232",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sumit De, M.D.
• Yvonne Deacon-Martin
• Gloria Carl Deacon, LPN
• Rhonda Carlene Deacon, RN
• Valerie Ruth Deacy
• Samuel Deadwyler III
• Delan Trevor Dealwis, M.D.
• Dean R Martin, MD, Facog, PC
• Ariel Z Dean
• Caroline Dean, MD

• Adult Health Nurse Practitioner in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.