Individual provider Active NPI

Gina Pecora, AGACNP-BC

  • Nurse Practitioner
  • West Caldwell, NJ
National Provider Identifier
1700615655
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ15104300 Issued in NJ
Practice address
24 Walden PL
West Caldwell, NJ 07006-8230
Phone
(973) 902-4035
NPI assigned
Jul 30, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ15104300 NJ Primary

Addresses

Primary practice location

24 Walden PL
West Caldwell, NJ 07006-8230

Mailing address

24 Walden PL
West Caldwell, NJ 07006-8230
Phone (973) 902-4035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20250618004206 NJ Practitioner - Nurse Practitioner 5395256093 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ15104300NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Firstline Health LLC CurrentSince May 1, 2025 Accepting new patients

Locations

905 Elizabeth Ave
Elizabeth, NJ 07201
Phone (866) 975-4488

Organizations & group practices 1

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": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1700615655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 WALDEN PL",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070068230",
            "telephone_number": "973-902-4035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 WALDEN PL",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070068230",
            "telephone_number": "973-902-4035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECORA",
        "first_name": "GINA",
        "credential": "AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-30",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ15104300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Caldwell, NJ

Sources for this page

Verify at the official NPI Registry.