Sunitha Jacob

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

F353417 Issued in NY

Practice address

51-55 N Route 9W
West Haverstraw, NY 10993-1195

Phone

(845) 786-4000

NPI assigned

Mar 5, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Group practices

Genesis Medical Health PCGroup PAC ID 9032308267, 44 clinicians

State of New York Comptrollers OfficeGroup PAC ID 0840101770, 171 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Hospital of Suffern Hospital, Suffern, NY, CCN 330158

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Genesis Medical Health PC

  • General Practice Physician
  • Spring Valley, NY
  • NPI 1295043099
  Medicare reassignment Care Compare group NPD
• State of New York Comptrollers Office

  • Rehabilitation Hospital Unit
  • West Haverstraw, NY
  • NPI 1235142472
  Medicare reassignment Care Compare group NPD
• State of New York

  • Specialist
  • West Haverstraw, NY
  • NPI 1508987348
  NPD
• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Staten Island, NY
  • NPI 1750469912
  NPD
• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Brewster, NY
  • NPI 1043335284
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Good Samaritan Hospital of Suffern

  • General Acute Care Hospital
  • Suffern, NY
  • NPI 1346213469
  Care Compare affiliation

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

{
    "created_epoch": "1709596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1003673948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 BLAUVELT RD",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109543601",
            "telephone_number": "914-426-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51-55 N ROUTE 9W",
            "city": "WEST HAVERSTRAW",
            "state": "NY",
            "postal_code": "109931195",
            "telephone_number": "845-786-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "SUNITHA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-05",
        "last_updated": "2024-03-05",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F353417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helen Hayes Hospital
• Krista Ann Hludzinski, O.T.R
• Tara Marlene Hoffman, M.S., CCC-SLP
• Robert David Holland, M.D.
• Hta of New York
• Minerve Jacques
• Jessy James
• Dhania Jean Baptiste
• Johncy Susan John, FNP-C
• Sweety John, FNP

• Primary Care Nurse Practitioner in West Haverstraw, NY
• Providers in West Haverstraw, NY by specialty
• Primary Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.