Jennifer Pettibone Gastenveld, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

327169 Issued in OH

Practice address

2123 Auburn Ave
Cincinnati, OH 45219-2906

Phone

(513) 206-1180

Fax

(513) 206-1183

NPI assigned

May 5, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Jennifer Ann Pettibone Former name

Medicare fee-for-service enrollment

Enrolled in OH, KY2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Christ Hospital Cardiovascular Associates LLCGroup PAC ID 1658449715, 151 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christ Hospital Hospital, Cincinnati, OH, CCN 360163

Merit-based Incentive Payment System (MIPS)

Final score

86.59 of 100Reported as group

Quality

77.64

Promoting interoperability

100

Improvement activities

40

Cost

77.68

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jegasten@yourcarecommunity.org

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.

• The Christ Hospital Cardiovascular Associates LLC

  • Cardiovascular Disease Physician
  • Cincinnati, OH
  • NPI 1497901458

  Adult Health, KY

  Medicare reassignment Care Compare group NPD
• The Christ Hospital Medical Associates, LLC

  • Internal Medicine Physician
  • Cincinnati, OH
  • NPI 1114107919

  Nurse Practitioner

  NPD (past)
• Christ Hospital Cardiology Assoc

  • Cardiovascular Disease Physician
  • Jersey City, NJ
  • NPI 1285771345
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christ Hospital

  • General Acute Care Hospital
  • Cincinnati, OH
  • NPI 1780633289
  Care Compare affiliation

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

{
    "created_epoch": "1273017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435276800000",
    "number": "1124346879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 WILLIAM HOWARD TAFT RD",
            "address_2": "2ND FLOOR, CBO 2-3",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192610",
            "telephone_number": "513-206-1180",
            "fax_number": "513-206-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 AUBURN AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192906",
            "telephone_number": "513-206-1180",
            "fax_number": "513-206-1183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASTENVELD",
        "first_name": "JENNIFER",
        "middle_name": "PETTIBONE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-05",
        "last_updated": "2015-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "327169",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "327169",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "327169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3050764",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100116680",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "PETTIBONE",
            "middle_name": "ANN",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristen Alyse Gassert
• Lauren Gassier, PHD
• Jill Gast, APRN.CNP
• Julianne Gast, PSY.D.
• Tricia Marie Gastelum, QMHS
• David A. Gaston, L.M.T.
• Jacob Gaston, PA-C
• Lashawnda C Gaston
• Naomi Victoria Gaston, LSW, MSSA
• Rebekkah Danielle Gaston, ATC

• Adult Health Nurse Practitioner in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Adult Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.