Individual provider Active NPI

Nicole Marie Jimenez, MSN, AGNP-BC, OCN

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1356893697
Registry record updated Feb 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F3078421 Issued in NY
Practice address
300 E 66TH St
New York, NY 10065-6800
Phone
(908) 433-5856
NPI assigned
Nov 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F3078421 NY Primary

Addresses

Primary practice location

300 E 66TH St
New York, NY 10065-6800

Mailing address

300 E 66TH St
New York, NY 10065-6800
Phone (646) 888-5209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 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

Enrollment IDStateProvider typePAC IDDetails
I20170216000794 NY Practitioner - Nurse Practitioner 6709169717 Reassigns benefits to 2 organizations
I20250826005278 NJ Practitioner - Nurse Practitioner 6709169717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Solid Tumor GroupGroup PAC ID 4082503354, 233 clinicians

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10021-6007
Phone (212) 639-2131

136 Mountain View Blvd
Basking Ridge, NJ 07920-3444

136 Mountainview Blvd
Basking Ridge, NJ 07920-3444
Phone (908) 542-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.55 of 100Reported as group
Quality
82.52
Improvement activities
40
Cost
72.02

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F3078421NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Sloan Kettering Cancer Center at Basking Ridge New Jersey CurrentSince May 31, 2025 Accepting new patients
Memorial Medical Consultation Group CurrentSince Sep 1, 2021 Accepting new patients
Memorial Solid Tumor Group CurrentSince Jan 13, 2017 Accepting new patients

Locations

136 Mountainview Blvd
Basking Ridge, NJ 07920
Phone (908) 542-3000

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

300 E 66th St
New York, NY 10065
Phone (347) 798-8856

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

Networks

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

Interoperability endpoints

  • Direct secure messaging: njimenez40110@mskcc.direct-ci.com

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518912000000",
    "number": "1356893697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E 66TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656800",
            "telephone_number": "646-888-5209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E 66TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656800",
            "telephone_number": "908-433-5856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "MSN, AGNP-BC, OCN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-03",
        "last_updated": "2018-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F3078421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.