Individual provider Active NPI

Andrew Jarjour, DO, MS

  • Emergency Medicine Physician
  • Bronx, NY
National Provider Identifier
1003566365
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A25065 Issued in CA
Practice address
4422 3Rd Ave RM 405
Bronx, NY 10457-2545
Phone
(718) 960-6240
Fax
(718) 960-6125
NPI assigned
Mar 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A25065 CA Primary

Addresses

Primary practice location

4422 3Rd Ave RM 405
Bronx, NY 10457-2545

Mailing address

4422 3Rd Ave RM 405
Bronx, NY 10457-2545
Phone (718) 960-6240

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260610004256 CA Practitioner - Emergency Medicine 2062984008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Western University of Health Sciences College of Dental Med, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4535 Dressier Rd NW
Canton, OH 44718-2545

5111 Llano Dr
Woodland Hills, CA 91364-3031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Master of Science

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": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1003566365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 3RD AVE RM 405",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572545",
            "telephone_number": "718-960-6240",
            "fax_number": "718-960-6125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4422 3RD AVE RM 405",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572545",
            "telephone_number": "718-960-6240",
            "fax_number": "718-960-6125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARJOUR",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DO, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A25065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.