Active NPI
Daniel Gabriel Jimenez, MD
- Vascular Surgery Physician
- Newark, NJ
National Provider Identifier
1104576818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- P24-00808
- Practice address
- 185 S Orange Ave
Newark, NJ 07103-2757 - Phone
- (973) 972-6295
- NPI assigned
- Mar 25, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | P24-00808 | NJ | Primary |
Addresses
Primary practice location
185 S Orange Ave
Newark, NJ 07103-2757
Mailing address
44 Irvine Turner Blvd Apt 316
Newark, NJ 07103-4604
Phone (240) 751-0825
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P24-00808 | NJ | MD | Vascular Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720137600000",
"number": "1104576818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 IRVINE TURNER BLVD APT 316",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071034604",
"telephone_number": "240-751-0825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 S ORANGE AVE",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071032757",
"telephone_number": "973-972-6295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIMENEZ",
"first_name": "DANIEL",
"middle_name": "GABRIEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-25",
"last_updated": "2024-07-05",
"certification_date": "2024-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "NJ",
"license": "P24-00808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.