Individual provider Active NPI

Jennifer Christine Giboney, M.D.

  • Pediatrics Physician
  • San Diego, CA
National Provider Identifier
1275895849
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A130768 Issued in CA
Practice address
3020 Childrens Way
San Diego, CA 92123-4223
Phone
(858) 966-8036
NPI assigned
Jun 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A130768 CA Primary

Addresses

Primary practice location

3020 Childrens Way
San Diego, CA 92123-4223

Mailing address

3020 Childrens Way
Mc5075
San Diego, CA 92123-4223
Phone (858) 966-8036

Other names 1

  • Dr. Jenny Christine Giboney Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170719003505 CA Practitioner - Pediatric Medicine 9739473893 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A130768CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rady Children'S Hospital San Diego CurrentSince Jun 3, 2017 Accepting new patients
Rady Children'S Hospital San Diego Pediatrics CurrentSince Jun 3, 2017 Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients

Locations

386 E H St
Ste 202
Chula Vista, CA 91910
Phone (619) 691-1108

25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 757-3277

3020 Childrens Way
#5003
San Diego, CA 92123
Phone (858) 309-6300

3020 Childrens Way
#5075
San Diego, CA 92123
Phone (858) 966-8036

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

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": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1275895849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY",
            "address_2": "MC5075",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-966-8036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-966-8036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBONEY",
        "first_name": "JENNIFER",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-11",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A130768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNY",
            "last_name": "GIBONEY",
            "middle_name": "CHRISTINE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.