Individual provider Active NPI

Jennifer Jimenez, M.D.

  • Pediatric Gastroenterology Physician
  • Neptune, NJ
National Provider Identifier
1073789905
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
25MA09326000 Issued in NJ
Practice address
61 Davis Ave
Suite 1
Neptune, NJ 07753-4401
Phone
(732) 776-4860
Fax
(732) 776-4867
NPI assigned
Apr 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 25MA09326000 NJ Primary

Addresses

Primary practice location

61 Davis Ave
Suite 1
Neptune, NJ 07753-4401

Mailing address

61 Davis Ave
Suite 1
Neptune, NJ 07753-4401
Phone (732) 776-4860

Other identifiers 1

IdentifierTypeStateIssuer
0372862MedicaidNJ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131019000090 NJ Practitioner - Pediatric Medicine 3476788878 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Rutgers School of Dental Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

30 Prospect Ave
Hackensack, NJ 07601-1915

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09326000NJMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 1, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC CurrentSince Sep 9, 2013 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 1, 2023 Accepting new patients

Locations

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

27 S Cooks Bridge Rd
Ste 2-20
Jackson, NJ 08527
Phone (732) 613-9144

61 Davis Ave
#1
Neptune, NJ 07753
Phone (732) 776-4271

61 Davis Ave
Neptune, NJ 07753
Phone (732) 776-4271

1944 State Route 33
Neptune, NJ 07753
Phone (732) 776-3787

19 Davis Ave
Fl 5
Neptune City, NJ 07753
Phone (732) 776-4860

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

Interoperability endpoints

  • Direct secure messaging: jennifer.jimenez@direct.hackensackmeridian.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394582400000",
    "number": "1073789905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 DAVIS AVE",
            "address_2": "SUITE 1",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534401",
            "telephone_number": "732-776-4860",
            "fax_number": "732-776-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 DAVIS AVE",
            "address_2": "SUITE 1",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534401",
            "telephone_number": "732-776-4860",
            "fax_number": "732-776-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-30",
        "last_updated": "2014-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NJ",
            "license": "25MA09326000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0372862",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune, NJ

Sources for this page

Verify at the official NPI Registry.