Jack Resnick, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

12375 Issued in NY

Practice address

520 Main St
Roosevelt Island, NY 10044-0032

Phone

(212) 832-2310

Fax

(212) 753-5507

NPI assigned

Jan 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Independence at Home - Physician House Calls for the Homebound, P.C.

  • Internal Medicine Physician
  • New York, NY
  • NPI 1851724363
  NPD (past) Authorized official

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1003894429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MAIN ST",
            "city": "ROOSEVELT ISLAND",
            "state": "NY",
            "postal_code": "100440032",
            "telephone_number": "212-832-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MAIN ST",
            "city": "ROOSEVELT ISLAND",
            "state": "NY",
            "postal_code": "100440032",
            "telephone_number": "212-832-2310",
            "fax_number": "212-753-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESNICK",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "12375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01771131",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Oommen, MD
• John Palmer, MD
• Kirtikumar Patel, MD
• Beena Philip-George, MD
• Kitnamma Rajaram, MD
• Stephanie Robertson, MD
• Jose Robles, MD
• Elizabeth Sanjorjo-Antolijao, MD
• Concepcion Santiago, MD
• Michael Schuster, MD

• Internal Medicine Physician in Roosevelt Island, NY
• Providers in Roosevelt Island, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.