Individual provider Active NPI

James Jacob

  • Certified Registered Nurse Anesthetist
  • Mineola, NY
National Provider Identifier
1164039855
Registry record updated Sep 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
632221 Issued in NY
Practice address
259 1St St
Mineola, NY 11501-3957
Phone
(516) 663-0333
NPI assigned
Sep 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 632221 NY Primary

Addresses

Primary practice location

259 1St St
Mineola, NY 11501-3957

Mailing address

10716 91St St
Ozone Park, NY 11417-1421
Phone (347) 255-5086

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210406000999 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 8224445481 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Cardiovascular Anesthesiologists, P.C.Group PAC ID 5799676623, 135 clinicians
North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

1000 N Village Ave
Rockville Center, NY 11570-1000
Phone (516) 627-6624

3 Centerock Rd
Suite 4
West Nyack, NY 10994-2214
Phone (914) 666-6777

4295 Hempstead Tpke
Bethpage, NY 11714-5713
Phone (516) 579-6000

530 1St Ave
New York, NY 10016-6402

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-6037

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214
  • Mercy Medical Center Hospital, Rockville Centre, NY, CCN 330259

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
632221NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince May 17, 2022 Accepting new patients
New York University CurrentSince May 17, 2022 Accepting new patients
New York Cardiovascular Anesthesiologists, P.C. CurrentSince May 1, 2025 Accepting new patients
CHS Physician Partners, P.C CurrentSince May 15, 2025 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
Long Island Anesthesia Physicians LLP CurrentSince Sep 1, 2021 Accepting new patients
New York University Current Accepting new patients
North Shore - Lij Anesthesiology, PC CurrentSince Oct 2, 2024 Accepting new patients
CHS Physician Partners, PC CurrentSince May 15, 2025 Accepting new patients

Locations

4295 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 520-2250

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

2200 Northern Blvd
Ste 100D
Greenvale, NY 11548
Phone (516) 243-8521

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

259 1st St
Mineola, NY 11501
Phone (516) 576-1820

4 Ohio Dr
New Hyde Park, NY 11042
Phone (516) 519-8260

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

3 Centerock Rd
Ste 4
West Nyack, NY 10994
Phone (914) 666-6777

Networks

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

Organizations & group practices 9

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1601078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601078400000",
    "number": "1164039855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10716 91ST ST",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114171421",
            "telephone_number": "347-255-5086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 1ST ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013957",
            "telephone_number": "516-663-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-26",
        "last_updated": "2020-09-26",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "632221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.