Individual provider Active NPI

Jake Namaroff, MSPAS, PA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1023920964
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
7901 4TH Ave
Brooklyn, NY 11209-3972
Phone
(800) 778-3090
NPI assigned
Sep 17, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

7901 4TH Ave
Brooklyn, NY 11209-3972

Mailing address

1101 President St Apt 812
Brooklyn, NY 11225-2075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1023920964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 PRESIDENT ST APT 812",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112252075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093972",
            "telephone_number": "800-778-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMAROFF",
        "first_name": "JAKE",
        "credential": "MSPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-17",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.