NPIMap

Individual provider Active NPI

Jennifer Gonzalez, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • East Setauket, NY
National Provider Identifier
1497853840
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
224617 Issued in NY
Practice address
7 S Jersey Ave Ste 1
East Setauket, NY 11733-2065
Phone
(631) 751-3000
Fax
(631) 751-0506
NPI assigned
Sep 20, 2006
Last updated
Aug 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 224617 NY Primary

Addresses

Primary practice location

7 S Jersey Ave Ste 1
East Setauket, NY 11733-2065

Mailing address

1500 Route 112 BLDG 4
Port Jefferson Station, NY 11776-8055
Phone (631) 751-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040414000690 NY Practitioner - Internal MedicinePractitioner - Geriatric Medicine 1153315825 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians

Practice addresses (Care Compare)

7 S Jersey Ave
Suite 1
East Setauket, NY 11733-2065
Phone (631) 751-3000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of New York Comptrollers Office CurrentSince Oct 25, 2012 Accepting new patients
State of New York Comptrollers Office Current Accepting new patients
North Shore Hematology Oncology Associates PC CurrentSince Feb 1, 2021 Accepting new patients
State of New York Comptrollers Office CurrentSince Oct 25, 2012 Accepting new patients

Locations

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

7 S Jersey Ave
Setauket, NY 11733
Phone (631) 377-3630

7 S Jersey Ave
Ste 1
Setauket, NY 11733
Phone (631) 689-2700

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

100 Patriots Rd
Stony Brook, NY 11790
Phone (631) 444-8500

6144 Route 25A
Ste 19
Wading River, NY 11792
Phone (631) 751-0000

Networks

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

Organizations & group practices 4

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1497853840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ROUTE 112 BLDG 4",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117768055",
            "telephone_number": "631-751-3000",
            "fax_number": "631-751-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 S JERSEY AVE STE 1",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117332065",
            "telephone_number": "631-751-3000",
            "fax_number": "631-751-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JENNIFER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "224617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.