Individual provider Active NPI

Gordon Huie, PA

  • Surgical Physician Assistant
  • Hackensack, NJ
National Provider Identifier
1801957626
Registry record updated Apr 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00046500 Issued in NJ
Practice address
360 Essex St Ste 303
Hackensack University Medical Center
Hackensack, NJ 07601-8566
Phone
(201) 336-8831
Fax
(201) 336-8908
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 25MP00046500 NJ Primary

Addresses

Primary practice location

360 Essex St Ste 303
Hackensack University Medical Center
Hackensack, NJ 07601-8566

Mailing address

360 Essex St Ste 303
Hackensack University Medical Center
Hackensack, NJ 07601-8566
Phone (201) 336-8831

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
I20080917000695 NJ Practitioner - Physician Assistant 0840367801 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00046500NJMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Sep 4, 2015 Accepting new patients
Premier Orthopaedics &Sports Medicine,PC PastSince Apr 1, 2001 Accepting new patients
Hand & Trauma Institute PastSince Sep 19, 2015 Accepting new patients

Locations

360 Essex St
Ste 303
Hackensack, NJ 07601
Phone (551) 996-3091

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

360 Essex St
Hackensack, NJ 07601
Phone (201) 336-8686

Interoperability endpoints

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

Organizations & group practices 4

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238544000000",
    "number": "1801957626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 ESSEX ST STE 303",
            "address_2": "HACKENSACK UNIVERSITY MEDICAL CENTER",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076018566",
            "telephone_number": "201-336-8831",
            "fax_number": "201-336-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 ESSEX ST STE 303",
            "address_2": "HACKENSACK UNIVERSITY MEDICAL CENTER",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076018566",
            "telephone_number": "201-336-8831",
            "fax_number": "201-336-8908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUIE",
        "first_name": "GORDON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2009-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00046500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.