Individual provider Active NPI

Veralyn Pena Gonzalez, PT

  • Physical Therapist
  • Jersey City, NJ
National Provider Identifier
1508265778
Registry record updated Aug 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00446700 Issued in NJ
Practice address
2757 Kennedy Blvd
Jersey City, NJ 07306-5507
Phone
(201) 333-8004
Fax
(201) 333-8425
NPI assigned
Aug 13, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA00446700 NJ Primary

Addresses

Primary practice location

2757 Kennedy Blvd
Jersey City, NJ 07306-5507

Mailing address

2757 Kennedy Blvd
Jersey City, NJ 07306-5507
Phone (201) 333-8004

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141113000894 NJ Practitioner - Physical Therapist in Private Practice 1557583259

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA00446700NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
A.B.K. Neurological Associates, PA CurrentSince Jan 1, 2014 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1407888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407888000000",
    "number": "1508265778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2757 KENNEDY BLVD",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073065507",
            "telephone_number": "201-333-8004",
            "fax_number": "201-333-8425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2757 KENNEDY BLVD",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073065507",
            "telephone_number": "201-333-8004",
            "fax_number": "201-333-8425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "VERALYN",
        "middle_name": "PENA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-13",
        "last_updated": "2014-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00446700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.