Internal Medicine of Rockland PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INTERNAL MEDICINE OF ROCKLAND PLLC

Practice address

20 Squadron Blvd
Suite 350
New City, NY 10956-5200

Phone

(845) 634-4567

Fax

(845) 634-4564

NPI assigned

Jun 12, 2006

Organization subpart

No

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

Authorized official

Name

Reena J Jacob, MDNPI 1720015746

Title

Owner

Phone

(845) 634-4567

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• REENA JACOB MD Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Reena J Jacob, MD

  • Internal Medicine Physician
  • New City, NY
  • NPI 1720015746
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218153600000",
    "number": "1114969458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 SQUADRON BLVD",
            "address_2": "SUITE 350",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109565200",
            "telephone_number": "845-634-4567",
            "fax_number": "845-634-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SQUADRON BLVD",
            "address_2": "SUITE 350",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109565200",
            "telephone_number": "845-634-4567",
            "fax_number": "845-634-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE OF ROCKLAND PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2008-08-08",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "REENA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-634-4567",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02148603",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REENA JACOB MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in New City, NY
• Providers in New City, 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 Aug 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.