Susan Sloan Jacoby, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

402856 Issued in NY

Practice address

3030 Westchester Ave
Purchase, NY 10577

Phone

(914) 848-8030

Fax

(914) 848-8031

NPI assigned

Jul 7, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT, NY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Westchester Medical Group, P.CGroup PAC ID 6406752963, 410 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles (2 of 6)

Locations

Networks

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

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

• Westchester Medical Group, P.C.

  • Critical Care Medicine (Internal Medicine) Physician
  • Rye Brook, NY
  • NPI 1881653822

  CT, NY

  Medicare reassignment Care Compare group NPD
• The Westchester Medical Group PC

  • Durable Medical Equipment & Medical Supplies
  • Greenwich, CT
  • NPI 1790560878
  NPD

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1124050273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 WESTCHESTER AVE",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "105772547",
            "telephone_number": "914-607-5730",
            "fax_number": "203-261-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 WESTCHESTER AVE",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "10577",
            "telephone_number": "914-848-8030",
            "fax_number": "914-848-8031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Stevens St",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CT",
            "postal_code": "068503852",
            "country_code": "US",
            "telephone_number": "203-852-2000 x3187",
            "fax_number": "203-852-2945",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "171 Huguenot St",
            "address_purpose": "LOCATION",
            "city": "New Rochelle",
            "state": "NY",
            "postal_code": "108017760",
            "country_code": "US",
            "telephone_number": "914-848-8030",
            "fax_number": "914-848-8031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Theall Rd",
            "address_purpose": "LOCATION",
            "city": "Rye",
            "state": "NY",
            "postal_code": "105801404",
            "country_code": "US",
            "telephone_number": "914-848-8030",
            "fax_number": "914-848-8031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "73 Market St",
            "address_purpose": "LOCATION",
            "city": "Yonkers",
            "state": "NY",
            "postal_code": "107107616",
            "country_code": "US",
            "telephone_number": "914-848-8030",
            "fax_number": "914-848-8031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "210 Westchester Ave",
            "address_purpose": "LOCATION",
            "city": "White Plains",
            "state": "NY",
            "postal_code": "106042901",
            "country_code": "US",
            "telephone_number": "914-848-8030",
            "fax_number": "914-848-8031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1084 N Broadway",
            "address_purpose": "LOCATION",
            "city": "Yonkers",
            "state": "NY",
            "postal_code": "107011107",
            "country_code": "US",
            "telephone_number": "914-848-8030",
            "fax_number": "914-848-8031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBY",
        "first_name": "SUSAN",
        "middle_name": "SLOAN",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "003284",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dina D. Iommazzo, DDS
• Marleine Ishak, MD
• Benjamin Israel
• Jeffrey H Jablon, M.D.
• Alexis Hope Jackman, MD
• Baraah Jafar, PHARMD
• Jessica Jagde
• Jan Zislis, M.D., PLLC
• James Jen, MD
• Adriana Patricia Jimenez Bahamon, SLP

• All providers in Purchase, NY
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.