Individual provider Active NPI

Gabriela Materassi

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1912708769
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ15298800 Issued in NJ
Practice address
5030 Broadway Ste 201
New York, NY 10034-1675
Phone
(212) 632-4749
NPI assigned
Mar 19, 2025
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ15298800 NJ Primary

Addresses

Primary practice location

5030 Broadway Ste 201
New York, NY 10034-1675

Mailing address

12302 Winterberry Way
Princeton, NJ 08540-6563
Phone (347) 684-4154

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250711001498 NY Practitioner - Nurse Practitioner 8628583416 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Upper Manhattan Mental Health Center, Inc.Group PAC ID 5698669729, 10 clinicians

Practice addresses (Care Compare)

1727 Amsterdam Ave
New York, NY 10031-4611
Phone 2126949200429

5030 Broadway
Suite 201
New York, NY 10034-1675
Phone (212) 795-9888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ15298800NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Board of Family and Children's Services, Inc. Psychiatric/Mental Health CurrentSince Jul 1, 2025 Accepting new patients
Jewish Board of Family & Childrens Services Inc CurrentSince Jul 1, 2025 Accepting new patients

Locations

1273 53rd St
Brooklyn, NY 11219
Phone (718) 435-5700

5030 Broadway
Ste 201
New York, NY 10034
Phone (212) 632-4749

Organizations & group practices 3

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": "1742342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1912708769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12302 WINTERBERRY WAY",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085406563",
            "telephone_number": "347-684-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 BROADWAY STE 201",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341675",
            "telephone_number": "212-632-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATERASSI",
        "first_name": "GABRIELA",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-03-19",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15298800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.