Jeanette M Gerould, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

25MP00293700 Issued in NJ

Practice address

663 Palisade Ave
Cliffside Park, NJ 07010-3012

Phone

(201) 943-9100

Fax

(201) 943-7308

NPI assigned

Oct 17, 2012

Last updated

Oct 17, 2012By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jgerould648994@direct.medicine.duke.edu

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.

• Duke University Health System, Inc.

  dba Duke University Hospital

  • Certified Registered Nurse Anesthetist
  • Durham, NC
  • NPI 1558392977
  Medicare reassignment NPD
• Duke University Health System, Inc.

  dba Duke Home Infusion

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Durham, NC
  • NPI 1427187525
  NPD
• Duke Health Integrated Practice, Inc.

  • General Practice Physician
  • Durham, NC
  • NPI 1205553369
  NPD (past)

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

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1700139540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 GALWAY PL",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663640",
            "telephone_number": "201-833-9500",
            "fax_number": "201-862-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "663 PALISADE AVE",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070103012",
            "telephone_number": "201-943-9100",
            "fax_number": "201-943-7308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEROULD",
        "first_name": "JEANETTE",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-17",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00293700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald John Garabed Jr., CRNA
• Patricia Garcia, LCSW
• Caridad Elizabeth Garciga, LPC
• Genesis Family Chiropractic, P.C.
• George Dawoud, D.D.S., LLC
• Shontaye Glover, CCC-SLP
• GM Garci
• Kenneth Lester Goldberg, D.M.D.
• Good Health, Inc. Dba Premier Pharmacy Services
• Michelle Kathleen Graziano, M.D.

• Surgical Physician Assistant in Cliffside Park, NJ
• Providers in Cliffside Park, NJ by specialty
• Surgical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.