Active NPI
Susan Hacker-Jakus, M.D.
- Internal Medicine Physician
- Bronx, NY
National Provider Identifier
1134248636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 71115
- Practice address
- 111 E 210TH St
Montefiore Medical Center - Ohs
Bronx, NY 10467-2401 - Phone
- (718) 920-5406
- Fax
- (718) 920-2435
- NPI assigned
- Mar 28, 2007
- Last updated
- Mar 7, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 71115 | NY | Primary |
| Medical Oncology Physician | 207RX0202X | 071115 | NY |
Addresses
Primary practice location
111 E 210TH St
Montefiore Medical Center - Ohs
Bronx, NY 10467-2401
Mailing address
111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 920-5406
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 071115 | Other | NY | MEDICAL ONCOLOGY |
| 71115 | Other | NY | INTERNAL MEDICINE |
| 1403971 | Other | NY | LICENSE |
Other names 1
- Dr. Susan Hacker
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
| License | State | Type | Specialty |
|---|---|---|---|
| 071115 | NY | MD | Pharmacist |
| 71115 | NY | MD | Internal Medicine Physician |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1134248636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 E 210TH ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104672401",
"telephone_number": "718-920-5406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 E 210TH ST",
"address_2": "MONTEFIORE MEDICAL CENTER - OHS",
"city": "BRONX",
"state": "NY",
"postal_code": "104672401",
"telephone_number": "718-920-5406",
"fax_number": "718-920-2435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HACKER-JAKUS",
"first_name": "SUSAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-28",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "71115",
"primary": true
},
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "NY",
"license": "071115",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL ONCOLOGY",
"identifier": "071115",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERNAL MEDICINE",
"identifier": "71115",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "1403971",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "HACKER",
"prefix": "DR.",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.