Gavriel Shimonov, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA12937200 Issued in NJ

Practice address

2290 W County Line Rd Ste 101
Jackson, NJ 08527-2156

Phone

(732) 645-9988

NPI assigned

Mar 29, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Family Practice

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: gavriel.shimonov.1@12833.direct.athenahealth.com

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1417651696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 W COUNTY LINE RD STE 101",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272156",
            "telephone_number": "732-645-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 W COUNTY LINE RD STE 101",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272156",
            "telephone_number": "732-645-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMONOV",
        "first_name": "GAVRIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-29",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA12937200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary F Sharobiem, PHARM D.
• Madison Shear
• Edward Shekhter, D.C.
• Hazel-Wood Shelaya Shepherd, LPN
• Shimmer Floortime
• Lauren Shivone, BCBA
• Shore ENT and Facial Plastics, PA
• Shore Homecare Services LLC
• Shore Point Obstetrics & Gynecology, P.C.
• Edward Shumulinskiy

• Family Medicine Physician in Jackson, NJ
• Providers in Jackson, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; 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.