Individual provider Active NPI

Jacob Saxon, OD

  • Optometrist
  • New York, NY
National Provider Identifier
1184422206
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
011141 Issued in NY
Practice address
1776 Broadway Ste 1410
New York, NY 10019-2007
Phone
(212) 877-7188
NPI assigned
Mar 5, 2025
Last updated
Nov 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 011141 NY Primary

Addresses

Primary practice location

1776 Broadway Ste 1410
New York, NY 10019-2007

Mailing address

PO Box 705
Lake Harmony, PA 18624-0705
Phone (570) 855-4875

Other practice location 1

211 Central Park W Ste 1E
New York, NY 10024-6054
Phone (212) 877-7188

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250529002472 NY Practitioner - Optometry 8426577792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jeffrey D. Nightingale, MD PCGroup PAC ID 5092606814, 3 clinicians

Practice addresses (Care Compare)

211 Central Park W
Suite 1E
New York, NY 10024-6054
Phone (212) 877-7188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011141NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey D. Nightingale, MD PC CurrentSince Apr 1, 2025 Accepting new patients

Locations

1776 Broadway
Ste 1410
New York, NY 10019
Phone (212) 877-7188

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1741132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1184422206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 705",
            "city": "LAKE HARMONY",
            "state": "PA",
            "postal_code": "186240705",
            "telephone_number": "570-855-4875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 BROADWAY STE 1410",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192007",
            "telephone_number": "212-877-7188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 Central Park W Ste 1E",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100246054",
            "country_code": "US",
            "telephone_number": "212-877-7188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAXON",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-05",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "011141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.