Kisha Jegede-Gabbidon, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F338617-1 Issued in NY

Practice address

11208 Springfield Blvd
Queens Village, NY 11429-2650

Phone

(929) 430-3811

NPI assigned

Oct 30, 2018

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 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

Interoperability endpoints

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

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.

• Ny Family Practice Physicians, PC

  • Primary Care Clinic/Center
  • Woodhaven, NY
  • NPI 1790936854
  Medicare reassignment NPD
• Apicha Community Health Center

  • Federally Qualified Health Center (FQHC)
  • New York, NY
  • NPI 1730303017
  Medicare reassignment NPD (past)
• Apicha Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Jackson Heights, NY
  • NPI 1396238283
  NPD
• Ny Family Medical Docs PC

  • Family Medicine Physician
  • Woodhaven, NY
  • NPI 1992204903
  NPD (past)

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1760959530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2417 JERICHO TPKE STE 279",
            "city": "GARDEN CITY PARK",
            "state": "NY",
            "postal_code": "110404710",
            "telephone_number": "929-430-3811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11208 SPRINGFIELD BLVD",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114292650",
            "telephone_number": "929-430-3811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17520 Hillside Ave",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114325773",
            "country_code": "US",
            "telephone_number": "718-298-9500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEGEDE-GABBIDON",
        "first_name": "KISHA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-30",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F338617-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norvy Jean
• Sophia Jean, FNP
• Schumann Jeancharles
• Cheryl Jefferson, MSW
• Kamell Jefferson
• Linda A. Jenkins, LCSW-R, PSYD, PHD
• Joshua Jennerjahn
• Wendy Jeremiah
• Shana Jerome
• Lovely Jeudy-Pierre, R.N

• Family Nurse Practitioner in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; 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.