Timothy C Gjenvick, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA03470600 Issued in NJ

Practice address

1600 Perrineville Rd
Monroe TWP, NJ 08831-4923

Phone

(609) 924-9300

Fax

(609) 430-9451

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Princeton Medical Group,P.a.

  • Internal Medicine Physician
  • Princeton, NJ
  • NPI 1063513679
  Medicare reassignment NPD
• Princeton Medical Group, P.a.

  • Non-Pharmacy Dispensing Site
  • Plainsboro, NJ
  • NPI 1144617937
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1003905498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 N HARRISON ST",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085403521",
            "telephone_number": "609-924-9300",
            "fax_number": "609-430-9481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 PERRINEVILLE RD",
            "city": "MONROE TWP",
            "state": "NJ",
            "postal_code": "088314923",
            "telephone_number": "609-924-9300",
            "fax_number": "609-430-9451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GJENVICK",
        "first_name": "TIMOTHY",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA03470600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHLTH ADMIN-PCP",
            "identifier": "162296",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO&NON HMO-PCP",
            "identifier": "2647154",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDE HEALTHCARE-PCP",
            "identifier": "249681",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD-PCP",
            "identifier": "LS403",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MED-PRINCETON",
            "identifier": "110246529",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH/IBC-PCP",
            "identifier": "0085740000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MED.-MONROE",
            "identifier": "110244288",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3150305",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward Demarco, C.AC.
• Leah Eichenstein
• Fiorentini Family Dentistry of Monroe
• Hiral P. Fontanilla, M.D.
• Steven John Giarratano, DDS
• Jory J Goldberg, M.D.
• Sunita Gulati, MD
• Paige Haugland, MA, NCC, LAC
• Heart-to-Heart Pediatric Cardiology, Inc.
• Hemcare Medical Clinic, PC

• Internal Medicine Physician in Monroe TWP, NJ
• Providers in Monroe TWP, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.