Tricia S Gravesande, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

26NJ00959600 Issued in NJ

Practice address

133 Elm St
Orange, NJ 07050-4001

Phone

(862) 224-0940

NPI assigned

Jan 17, 2020

Sex

Female

Sole proprietor

Yes

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 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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Associates of Montclair LLCGroup PAC ID 0244522241, 24 clinicians

Citywide Urgent Care NJ LLCGroup PAC ID 0042628018, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Citywide Urgent Care NJ LLC

  • Urgent Care Clinic/Center
  • Bloomfield, NJ
  • NPI 1689259822
  Medicare reassignment Care Compare group NPD
• Emergency Associates of Montclair LLC

  • Emergency Medicine Physician
  • Montclair, NJ
  • NPI 1598112146
  Medicare reassignment Care Compare group NPD
• Emergency Physician Associates of North Jersey P C

  • Emergency Medicine Physician
  • Summit, NJ
  • NPI 1497783419
  Medicare reassignment NPD
• Ennoble HC NJ PC

  • Geriatric Medicine (Family Medicine) Physician
  • Hackensack, NJ
  • NPI 1306500764
  Medicare reassignment NPD
• Ihpnj ER LLC

  • Emergency Medicine Physician
  • Hoboken, NJ
  • NPI 1225750946
  Medicare reassignment NPD

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1730719782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 ELM ST",
            "city": "ORANGE",
            "state": "NJ",
            "postal_code": "070504001",
            "telephone_number": "186-224-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 ELM ST",
            "city": "ORANGE",
            "state": "NJ",
            "postal_code": "070504001",
            "telephone_number": "862-224-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVESANDE",
        "first_name": "TRICIA",
        "middle_name": "S",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-17",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00959600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dorothy C Handfield
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• Harris Dental LLC
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• Gerontology Nurse Practitioner in Orange, NJ
• Providers in Orange, NJ by specialty
• Gerontology Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; 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.