Individual provider Active NPI

Jamal Cinque Harris, MD, MPH

  • Pediatrics Physician
  • San Francisco, CA
National Provider Identifier
1154501450
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A105905 Issued in CA
Practice address
1001 Potrero Ave
Mail Stop 6E
San Francisco, CA 94110-3518
Phone
(415) 206-8361
Fax
(415) 206-3686
NPI assigned
Nov 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A105905 CA Primary

Addresses

Primary practice location

1001 Potrero Ave
Mail Stop 6E
San Francisco, CA 94110-3518

Mailing address

1001 Potrero Ave
Mail Stop 6E
San Francisco, CA 94110-3518
Phone (415) 206-8361

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jharris333648@nyumc.direct-ci.com NYU Langone Hospitals

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080626000560 NY Practitioner - Pediatric Medicine 0547332199 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A105905CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NYU Langone Hospitals CurrentSince Nov 4, 2019 Accepting new patients
Montefiore Medical Center Pediatrics CurrentSince Feb 18, 2017 Accepting new patients
NYU Langone Hospitals CurrentSince Nov 4, 2019 Accepting new patients
NYU Langone Hospitals Current Accepting new patients
Montefiore Medical Center CurrentSince Feb 18, 2017 Accepting new patients
Maimonides Medical Center Current Accepting new patients
Montefiore Mount Vernon Hospital Past Accepting new patients
Tribeca Pediatrics, PLLC Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

305 E 161st St
Bronx, NY 10451
Phone (718) 410-4711

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185

301 E 17th St
New York, NY 10003
Phone (212) 460-0125

Interoperability endpoints

  • Direct secure messaging: jamalharris@mai.allscriptsdirect.net

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1154501450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE",
            "address_2": "MAIL STOP 6E",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "415-206-8361",
            "fax_number": "415-206-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE",
            "address_2": "MAIL STOP 6E",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "415-206-8361",
            "fax_number": "415-206-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JAMAL",
        "middle_name": "CINQUE",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-05",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A105905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jharris333648@nyumc.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "NYU Langone Hospitals",
            "address_1": "150 55th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112202559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.