Individual provider Active NPI

Jennifer Vallarta Gopez, APN-C

  • Nurse Practitioner
  • New Brunswick, NJ
National Provider Identifier
1487691804
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NN111089 Issued in NJ
Practice address
1 Robert Wood Johnson PL BLDG 5TH
New Brunswick, NJ 08901-1928
Phone
(732) 235-7231
Fax
(732) 235-8963
NPI assigned
Jun 2, 2006
Last updated
Jun 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NN111089 NJ Primary
Cardiovascular Disease Physician 207RC0000X 25MA04423700 NJ

Addresses

Primary practice location

1 Robert Wood Johnson PL BLDG 5TH
New Brunswick, NJ 08901-1928

Mailing address

5 Palace CT
Monroe Township, NJ 08831-2176
Phone (732) 690-3473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070913000000 NJ Practitioner - Nurse Practitioner 3173617768 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

125 Paterson St
New Brunswick, NJ 08901-1962
Phone (732) 235-7800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
25MA04423700NJMDSpecialist
26NN111089NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Neurosurgery Faculty Current Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Feb 1, 2021 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Feb 1, 2021 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty Past Accepting new patients
Cardiology Associates of Somerset County,P.a. Cardiovascular Disease Past Accepting new patients

Locations

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

125 Paterson St
New Brunswick, NJ 08901
Phone (732) 235-6511

125 Paterson St
Ste 4100
New Brunswick, NJ 08901
Phone (732) 235-7756

66 W Gilbert St
Ste 2
Tinton Falls, NJ 07701
Phone (732) 212-0051

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DICCDA
  • Direct secure messaging: jgopez18285@epicdirect.rwjbh.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1487691804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PALACE CT",
            "city": "MONROE TOWNSHIP",
            "state": "NJ",
            "postal_code": "088312176",
            "telephone_number": "732-690-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ROBERT WOOD JOHNSON PL BLDG 5TH",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011928",
            "telephone_number": "732-235-7231",
            "fax_number": "732-235-8963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOPEZ",
        "first_name": "JENNIFER",
        "middle_name": "VALLARTA",
        "name_prefix": "Mrs.",
        "credential": "APN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NN111089",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA04423700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.