Individual provider Active NPI

Gezime Djonovic

  • Speech-Language Pathologist
  • Lincoln Park, NJ
National Provider Identifier
1235543547
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS00774800 Issued in NJ
Practice address
59 Beaverbrook Rd Ste 303C
Lincoln Park, NJ 07035-1772
Phone
(201) 675-3396
NPI assigned
Jun 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 30003391 NC
Speech-Language Pathologist 235Z00000X 41YS00774800 NJ Primary

Addresses

Primary practice location

59 Beaverbrook Rd Ste 303C
Lincoln Park, NJ 07035-1772

Mailing address

59 Beaverbrook Rd Ste 303C
Lincoln Park, NJ 07035-1772
Phone (201) 675-3396

Other practice location 1

103 Kilmayne Dr Ste A-7
Cary, NC 27511-4425
Phone (919) 885-3411

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30003391NCMDSpeech-Language Pathologist
41YS00774800NJMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Speech Therapy LLC Speech-Language Pathologist CurrentSince Feb 23, 2020 Accepting new patients

Locations

103 Kilmayne Dr
Ste A7
Cary, NC 27511
Phone (919) 885-3411

1870 Route 27
Ste 1B
Edison, NJ 08817
Phone (201) 660-2227

59 Beaverbrook Rd
Ste 303C
Lincoln Park, NJ 07035
Phone (201) 675-3396

Organizations & group practices 1

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": "1402617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1235543547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 BEAVERBROOK RD STE 303C",
            "city": "LINCOLN PARK",
            "state": "NJ",
            "postal_code": "070351772",
            "telephone_number": "201-675-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 BEAVERBROOK RD STE 303C",
            "city": "LINCOLN PARK",
            "state": "NJ",
            "postal_code": "070351772",
            "telephone_number": "201-675-3396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Kilmayne Dr Ste A-7",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275114425",
            "country_code": "US",
            "telephone_number": "919-885-3411",
            "fax_number": "973-646-8973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DJONOVIC",
        "first_name": "GEZIME",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-13",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30003391",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00774800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.