Individual provider Active NPI

Jimena L Gonzales, RDN

  • Registered Dietitian
  • Old Bridge, NJ
National Provider Identifier
1679374474
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86370738 Issued in NJ
Practice address
3F Brynwood GDNS Apt 34
Old Bridge, NJ 08857-2349
Phone
(908) 708-7211
NPI assigned
Mar 19, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86370738 NJ Primary

Addresses

Primary practice location

3F Brynwood GDNS Apt 34
Old Bridge, NJ 08857-2349

Mailing address

3F Brynwood GDNS Apt 34
Old Bridge, NJ 08857-2349
Phone (908) 708-7211

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250516002852 NJ Practitioner - Registered Dietitian Or Nutrition Professional 8729506399 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86370738NJMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Peter'S University Hospital CurrentSince Apr 7, 2025 Accepting new patients
Saint Peter'S University Hospital CurrentSince Apr 7, 2025 Accepting new patients

Locations

254 Easton Ave
Fl 1
New Brunswick, NJ 08901
Phone (732) 745-8571

123 How Ln
New Brunswick, NJ 08901
Phone (732) 448-1000

254 Easton Ave
New Brunswick, NJ 08901
Phone (732) 565-5453

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8568/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1742342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1679374474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3F BRYNWOOD GDNS APT 34",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572349",
            "telephone_number": "908-708-7211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3F BRYNWOOD GDNS APT 34",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572349",
            "telephone_number": "908-708-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "JIMENA",
        "middle_name": "L",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-19",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NJ",
            "license": "86370738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; 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.