Individual provider Active NPI

Jake Abbuhl

  • Pediatrics Physician
  • Albany, NY
National Provider Identifier
1114504313
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
332135 Issued in NY
Practice address
81 Schoolhouse Rd
Albany, NY 12203-3834
Phone
(518) 456-1211
NPI assigned
Mar 25, 2021
Last updated
Sep 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 64407 NY
Pediatrics Physician 208000000X 332135 NY Primary

Addresses

Primary practice location

81 Schoolhouse Rd
Albany, NY 12203-3834

Mailing address

81 Schoolhouse Rd
Albany, NY 12203-3834

Other practice location 1

47 New Scotland Avenue, Department of Pediatrics
Albany, NY 12208-3412
Phone (518) 262-5626

Other names 1

  • Jacob Abbuhl Other name

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
64407NYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Schoolhouse Road Pediatric, PC Pediatrics PastSince Sep 15, 2024 Accepting new patients
Schoolhouse Pediatrics South Pediatrics PastSince Sep 15, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: schoolhousepediatrics.jakeabbuhl@160615.advancedmd-direct.com

Organizations & group practices 2

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": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1114504313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 SCHOOLHOUSE RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122033834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 SCHOOLHOUSE RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122033834",
            "telephone_number": "518-456-1211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 New Scotland Avenue, Department of Pediatrics",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122083412",
            "country_code": "US",
            "telephone_number": "518-262-5626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABBUHL",
        "first_name": "JAKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "64407",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "332135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACOB",
            "last_name": "ABBUHL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.