Individual provider Active NPI

Jicenis G Pincay, MS, RDN, CDCES

  • Registered Dietitian
  • Rockville Centre, NY
National Provider Identifier
1174193395
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
2000 N Village Ave
Rockville Centre, NY 11570-1078
Phone
(516) 705-2177
NPI assigned
Jun 29, 2021
Last updated
Aug 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU Primary

Addresses

Primary practice location

2000 N Village Ave
Rockville Centre, NY 11570-1078

Mailing address

8606 86TH Ave
Woodhaven, NY 11421-1258

Other names 1

  • Mrs. Jicenis G Gonzalez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231110002059 NY Practitioner - Registered Dietitian Or Nutrition Professional 8820445919 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
011544NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Sep 23, 2024 Accepting new patients
CHS Physician Partners, P.C CurrentSince Sep 10, 2023 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
North Shore - Lij Medical PC CurrentSince Sep 23, 2024 Accepting new patients
CHS Physician Partners, PC CurrentSince Sep 10, 2023 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

865 Northern Blvd
Ste 205
Great Neck, NY 11021
Phone (516) 622-5155

300 Community Dr
Manhasset, NY 11030

1111 Marcus Ave
Ste M10C
New Hyde Park, NY 11042
Phone (516) 266-3500

4 Ohio Dr
Ste 200
New Hyde Park, NY 11042
Phone (516) 775-4545

10538 Rockaway Beach Blvd
Rockaway Park, NY 11694
Phone (718) 318-3434

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

2000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1777

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1174193395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8606 86TH AVE",
            "city": "WOODHAVEN",
            "state": "NY",
            "postal_code": "114211258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N VILLAGE AVE",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115701078",
            "telephone_number": "516-705-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINCAY",
        "first_name": "JICENIS",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "MS, RDN, CDCES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JICENIS",
            "last_name": "GONZALEZ",
            "middle_name": "G",
            "prefix": "MRS.",
            "credential": "MS, RDN, CDCES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rockville Centre, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.