Jacqueline Pascual Pontiveros, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

624212 Issued in NY

Practice address

22 Marie PL Unit 10
Maplewood, NJ 07040-3402

Phone

(917) 680-7258

NPI assigned

Feb 25, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jacqueline Louise Pascual Pontiveros Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1447610043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 MARIE PL UNIT 10",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403402",
            "telephone_number": "917-680-7258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MARIE PL UNIT 10",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403402",
            "telephone_number": "917-680-7258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONTIVEROS",
        "first_name": "JACQUELINE",
        "middle_name": "PASCUAL",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-25",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "624212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE LOUISE",
            "last_name": "PONTIVEROS",
            "middle_name": "PASCUAL",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Registered Nurse in Maplewood, NJ
• Providers in Maplewood, NJ by specialty
• Registered Nurse in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; 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.