Active NPI
John R. Jakubek, M.D.
- Anesthesiology Physician
- Canfield, OH
National Provider Identifier
1144266867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 35-049919
- Practice address
- 4147 Westford Dr
Canfield, OH 44406-8086 - Phone
- (330) 702-1489
- Fax
- (330) 702-1545
- NPI assigned
- Jun 21, 2006
- Last updated
- Sep 22, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 35-049919 | OH | Primary |
Addresses
Primary practice location
4147 Westford Dr
Canfield, OH 44406-8086
Mailing address
4135 Boardman Canfield Rd
Suite 101
Canfield, OH 44406-9803
Phone (330) 286-5330
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 050028962 | Other | OH | MEDICARE RAILROAD |
| 0578085 | Medicaid | OH |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35-049919 | OH | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411344000000",
"number": "1144266867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4135 BOARDMAN CANFIELD RD",
"address_2": "SUITE 101",
"city": "CANFIELD",
"state": "OH",
"postal_code": "444069803",
"telephone_number": "330-286-5330",
"fax_number": "330-286-5396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4147 WESTFORD DR",
"city": "CANFIELD",
"state": "OH",
"postal_code": "444068086",
"telephone_number": "330-702-1489",
"fax_number": "330-702-1545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAKUBEK",
"first_name": "JOHN",
"middle_name": "R.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-21",
"last_updated": "2014-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "OH",
"license": "35-049919",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "050028962",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0578085",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Canfield, OH
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- Johanna Ivanac, ORT/L
- Anginette James
- Josephine J Jarbeck, CRNA
- Hayley Jenkins, OTR/L
- Jjdbt Pediatrics (After Hours Pediatrics)
- Jla Senior Footcare Oh PA LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.