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THARA L GUILLORY
NPI 1083581490
Nurse Practitioner - Gerontology in Avenel, NJ

Active since October 21, 2025PECOS Enrolled
1300 STATION DR APT 1303, AVENEL, NJ 07001(386) 868-9658 Get Directions Write a Review

NPPES record last updated: August 25, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Thara L Guillory NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THARA L GUILLORY (NPI 1083581490) is an individual gerontology provider in Avenel, New Jersey, licensed in New Jersey (26NJ15465900) and active in the NPI registry since October 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1083581490
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameTHARA L GUILLORY
Location Address1300 STATION DR APT 1303Avenel, NJ 07001-1869
Mailing Address1300 Station Dr Apt 1303Avenel, NJ 07001-1869 · (386) 868-9658
Phone(386) 868-9658
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateOctober 21, 2025
Last NPPES UpdateAugust 25, 2026
NPPES CertifiedAugust 25, 2026
✔ NPI 1083581490 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in NJ · 26NJ15465900
Also ListedRegistered Nurse · Registered Nurse First AssistantTaxonomy 163WR0006X · License RN9573108 (FL)
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License N10571 (NY), RN9573108 (FL)
1300 STATION DR APT 1303, Avenel, NJ 07001
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Thara L Guillory is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1951874205
PECOS Enrollment IDI20260626004190
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Thara Guillory reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Great Health Medical New Jersey PC
33 mi
Family Medicine
101 CHASE AVE STE 105
Lakewood, NJ 08701
  • Reassigned Medicare billing, New Jersey enrollment
  • Medicare enrollment name: Simon Fensterszaub Do Nj PC
  • 28 clinicians in this Medicare group
NPI 1417681008 (212) 201-1252

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07001 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$98.09 typical visit price
range $63.84 – $190.92
Typical copayment $24.52 (range $15.96 – $47.73)
Most-billed visit code 99203
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Thara Guillory's NPI number?

The NPI number for Thara Guillory is 1083581490. It was assigned to this individual provider in the NPPES registry on October 21, 2025.

Where is Thara Guillory located?

Thara Guillory practices at 1300 Station Dr Apt 1303, Avenel, NJ 07001. The listed phone number is (386) 868-9658.

What is Thara Guillory's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Thara Guillory enrolled in Medicare?

Yes. Thara Guillory is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Thara Guillory's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Thara Guillory reassigns Medicare benefits to Great Health Medical New Jersey PC (Lakewood, NJ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Thara Guillory's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Thara Guillory accept?

Health plans from Oscar Health list Thara Guillory as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Thara Guillory was last updated on August 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 60 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.