Individual provider Active NPI

John Gillick, M.D.

  • Neurological Surgery Physician
  • Newark, NJ
National Provider Identifier
1821499344
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
25MA10152100 Issued in NJ
Practice address
90 Bergen St Ste 8100
Newark, NJ 07103-2425
Phone
(973) 972-2323
NPI assigned
Sep 16, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 283356 NY
Student in an Organized Health Care Education/Training Program 390200000X
Neurological Surgery Physician 207T00000X 25MA10152100 NJ Primary

Addresses

Primary practice location

90 Bergen St Ste 8100
Newark, NJ 07103-2425

Mailing address

90 Bergen Street
Suite 8100
Newark, NJ 07103
Phone (973) 972-2323

Other practice location 1

234 E 149th St
Bronx, NY 10451-5504
Phone (718) 579-5274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170612000757 NY Practitioner - NeurosurgeryPractitioner - Orthopedic Surgery 3577850718 Reassigns benefits to 1 organization
I20171023001560 NJ Practitioner - Neurosurgery 3577850718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
New York Medical College, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physician Associates of New Jersey IncGroup PAC ID 9830003417, 374 clinicians

Practice addresses (Care Compare)

90 Bergen St
Suite 8100
Newark, NJ 07103-2425
Phone (862) 361-3840

Hospital & facility affiliations

  • The University Hospital Hospital, Newark, NJ, CCN 310119
  • Cooperman Barnabas Medical Center Hospital, Livingston, NJ, CCN 310076

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion37
Laminectomy or laminotomy (partial removal of spine bones)11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA10152100NJMDNeurological Surgery Physician
283356NYMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Associates of New Jersey Inc Neurological Surgery CurrentSince Sep 1, 2017 Accepting new patients
Downtown Bronx Medical Associates PC CurrentSince Apr 25, 2017 Accepting new patients
University Physician Associates of New Jersey Inc CurrentSince Sep 1, 2017 Accepting new patients
University Hospital Past Accepting new patients
University Physician Associates of New Jersey Inc Past Accepting new patients

Locations

90 Bergen St
#8100
Newark, NJ 07103
Phone (973) 972-2323

90 Bergen St
Ste 8100
Newark, NJ 07103
Phone (973) 972-0037

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

Interoperability endpoints

  • Direct secure messaging: jgillick843225@nychhc.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1821499344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 BERGEN STREET",
            "address_2": "SUITE 8100",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07103",
            "telephone_number": "973-972-2323",
            "fax_number": "973-972-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BERGEN ST STE 8100",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-2323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "234 E 149th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104515504",
            "country_code": "US",
            "telephone_number": "718-579-5274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLICK",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "283356",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NJ",
            "license": "25MA10152100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.