Miryam Anci-Jimenez, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

25NJ15164400 Issued in NJ

Practice address

796 Northfield Ave
West Orange, NJ 07052-1025

Phone

(973) 842-4272

Fax

(732) 997-3022

NPI assigned

Jul 22, 2024

Last updated

Oct 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• The Radiology Group of New Jersey, LLC

  dba The Medical Group of New Jersey

  • Multi-Specialty Clinic/Center
  • Hackettstown, NJ
  • NPI 1174010540
  NPD (past)

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1902634975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "796 NORTHFIELD AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521025",
            "telephone_number": "973-842-4272",
            "fax_number": "732-997-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "796 NORTHFIELD AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521025",
            "telephone_number": "973-842-4272",
            "fax_number": "732-997-3022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "73 Oak Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Newfoundland",
            "state": "NJ",
            "postal_code": "074351403",
            "country_code": "US",
            "telephone_number": "973-663-1143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANCI-JIMENEZ",
        "first_name": "MIRYAM",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "25NJ15164400",
            "primary": true
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NJ",
            "license": "26NR18079700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elinor Anan, M.D
• Anchor Behavioral Solutions LLC
• Anchor Behavioral Solutions LLC
• Anchor Behavioral Solutions LLC
• Anchor Behavioral Solutions LLC
• Andreas a. Savopoulos,M.D.P.a.
• Patricia Andreville, REGISTERED NURSE
• Anesthesia Group of Orange
• Anjali R. Gupta, M.D. P.C.
• Anna Kirshblum LLC

• Family Nurse Practitioner in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.