Individual provider Active NPI

Jason Pachman, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1104808922
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
210669 Issued in NY
Practice address
317 E 17TH St
2ND Floor
New York, NY 10003-3804
Phone
(212) 420-2885
Fax
(212) 844-1762
NPI assigned
Nov 17, 2005
Last updated
May 5, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 210669 NY Primary

Addresses

Primary practice location

317 E 17TH St
2ND Floor
New York, NY 10003-3804

Mailing address

PO Box 95000-2433
Phil, PA 19195-2433
Phone (212) 420-2885

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040824001473 NY Practitioner - Internal Medicine 9830163898 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
210669NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Internal Medicine CurrentSince Nov 20, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 20, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai Internal Medicine Past Accepting new patients
Beth Israel Medical Center Internal Medicine Past Accepting new patients
Bimc Faculty Practice Past Accepting new patients

Locations

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

10 Union Sq E
#3
New York, NY 10003
Phone (212) 420-4145

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

55 E 34th St
New York, NY 10016
Phone (212) 252-6131

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1104808922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000-2433",
            "city": "PHIL",
            "state": "PA",
            "postal_code": "191952433",
            "telephone_number": "212-420-2885",
            "fax_number": "212-844-1762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 E 17TH ST",
            "address_2": "2ND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033804",
            "telephone_number": "212-420-2885",
            "fax_number": "212-844-1762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHMAN",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "210669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.