Active NPI
Gabrielle Phillip, MD
- Pediatrics Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 300275
- Practice address
- 622 W 168TH St
New York, NY 10032-3720 - Phone
- (212) 305-4700
- NPI assigned
- May 18, 2016
- Last updated
- Oct 9, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 300275 | NY | |
| Pediatrics Physician | 208000000X | 300275 | NY | Primary |
| Pediatrics Physician | 208000000X | 21419 | ND | |
| Pediatrics Physician | 208000000X | 25IA12638500 | NJ |
Addresses
Primary practice location
622 W 168TH St
New York, NY 10032-3720
Mailing address
1465 Maple Ave
Hillside, NJ 07205-1548
Phone (917) 226-0743
Other practice location 1
241 37th St
Brooklyn, NY 11232-2417
Phone (718) 232-1500
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) | |
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) | |
| Direct Messaging Address | CWID@direct.nyp.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, ND
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 300275 | NY | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Sanford Medical Center Fargo | Emergency Medicine | Current | Accepting new patients |
| Trustees of Columbia University in the City of New York | Pediatrics | Current | Accepting new patients |
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Emergency Medicine | Current | Accepting new patients |
| PM Pediatrics PC | Pediatrics | Past | Accepting new patients |
Locations
1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445
161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559
622 W 168th St
New York, NY 10032
Phone (212) 305-4931
Interoperability endpoints
- gap9041@direct.nyp.org
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
Organizations & group practices 6
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.
-
- Surgery Physician
- New York, NY
- NPI 1508266347
Pediatrics
-
dba Sanford 1717 Medical Building
- Family Medicine Physician
- West Fargo, ND
- NPI 1184917924
Emergency Medicine
-
- Internal Medicine Physician
- New York, NY
- NPI 1699289488
Emergency Medicine
-
dba Sanford LaMoure Clinic
- Rural Health Clinic/Center
- Lamoure, ND
- NPI 1164439196
-
dba Sanford POWER Center
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
-
dba PM Pediatrics of Mamaroneck
- Urgent Care Clinic/Center
- Syosset, NY
- NPI 1730212390
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1791504000000",
"number": "1790132801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1465 MAPLE AVE",
"city": "HILLSIDE",
"state": "NJ",
"postal_code": "072051548",
"telephone_number": "917-226-0743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "622 W 168TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323720",
"telephone_number": "212-305-4700"
}
],
"practiceLocations": [
{
"address_1": "241 37th St",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112322417",
"country_code": "US",
"telephone_number": "718-232-1500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PHILLIP",
"first_name": "GABRIELLE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-18",
"last_updated": "2026-10-09",
"certification_date": "2026-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NY",
"license": "300275",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "300275",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "ND",
"license": "21419",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25IA12638500",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "OTHER",
"address_1": "622 W 168th St",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100323720",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "OTHER",
"address_1": "622 W 168th St",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100323720",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "CWID@direct.nyp.org",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct Address",
"address_1": "622 W 168th St",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100323720",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2026; 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.