Active NPI
Jennifer Gondelman, APRN, BC, RNCS
- Psychiatric/Mental Health Clinical Nurse Specialist
- Milton, MA
National Provider Identifier
1619953098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Clinical Nurse Specialist
- License
- 250606
- Practice address
- 324 Highland St
Milton, MA 02186-4432 - Phone
- (617) 690-2520
- Fax
- (617) 298-2607
- NPI assigned
- Dec 19, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Clinical Nurse Specialist | 364SP0808X | 250606 | MA | Primary |
Addresses
Primary practice location
324 Highland St
Milton, MA 02186-4432
Mailing address
324 Highland St
Milton, MA 02186-4432
Phone (617) 650-2520
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 24, 2020 through Oct 24, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Specialist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 250606 | MA | MD | Psychiatric/Mental Health Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603497600000",
"number": "1619953098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "324 HIGHLAND ST",
"city": "MILTON",
"state": "MA",
"postal_code": "021864432",
"telephone_number": "617-650-2520",
"fax_number": "617-298-2607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "324 HIGHLAND ST",
"city": "MILTON",
"state": "MA",
"postal_code": "021864432",
"telephone_number": "617-690-2520",
"fax_number": "617-298-2607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONDELMAN",
"first_name": "JENNIFER",
"credential": "APRN, BC, RNCS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-19",
"last_updated": "2020-10-24",
"certification_date": "2020-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "364SP0808X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
"state": "MA",
"license": "250606",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.