Active NPI
Jacob M McClean, D.O.
- Psychiatry Physician
- South Miami, FL
National Provider Identifier
1104265180
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(4) exclusion effective Aug 18, 2022.
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- UO3093
- Practice address
- 7031 SW 62ND Ave
South Miami, FL 33143-4701 - Phone
- (305) 284-7500
- NPI assigned
- Jun 23, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | UO3093 | FL | Primary |
Addresses
Primary practice location
7031 SW 62ND Ave
South Miami, FL 33143-4701
Mailing address
31 W 20TH Street
Riviera Beach, FL 33404
Phone (561) 229-1659
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| UO3093 | FL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440547200000",
"number": "1104265180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 W 20TH STREET",
"city": "RIVIERA BEACH",
"state": "FL",
"postal_code": "33404",
"telephone_number": "561-229-1659",
"fax_number": "561-331-2715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7031 SW 62ND AVE",
"city": "SOUTH MIAMI",
"state": "FL",
"postal_code": "331434701",
"telephone_number": "305-284-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLEAN",
"first_name": "JACOB",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-23",
"last_updated": "2015-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "UO3093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.