Individual provider Active NPI

Jared Macklin

  • Gastroenterology Physician
  • Purchase, NY
National Provider Identifier
1205279247
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
311211 Issued in NY
Practice address
3030 Westchester Ave
Purchase, NY 10577-2574
Phone
(914) 682-6466
Fax
(914) 681-5222
NPI assigned
Apr 9, 2013
Last updated
Jul 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 62570 CT
Gastroenterology Physician 207RG0100X 311211 NY Primary

Addresses

Primary practice location

3030 Westchester Ave
Purchase, NY 10577-2574

Mailing address

800 Westchester Ave
Ste N715
Rye Brook, NY 10573-1369
Phone (914) 607-5730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191008000244 CT Practitioner - Gastroenterology 5991099632 Reassigns benefits to 2 organizations
I20210616002646 NY Practitioner - Gastroenterology 5991099632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
State University of New York Downstate Medical Center, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Westchester Medical Group, P.CGroup PAC ID 6406752963, 410 clinicians

Practice addresses (Care Compare)

3030 Westchester Ave
Purchase, NY 10577-2574
Phone (914) 831-4100

5 Perryridge Rd
Greenwich, CT 06830-4608
Phone (203) 863-3000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy94
Upper gastrointestinal (GI) endoscopy for acid reflux55

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. CurrentSince Oct 1, 2019 Accepting new patients
The Westchester Medical Group PC CurrentSince May 1, 2021 Accepting new patients
Westchester Medical Group, P.C. Gastroenterology CurrentSince May 1, 2021 Accepting new patients

Locations

5 Perryridge Rd
Greenwich, CT 06830
Phone (203) 661-5330

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

3030 Westchester Ave
Purchase, NY 10577
Phone (914) 682-6435

800 Westchester Ave
Ste N715
Rye Brook, NY 10573
Phone (914) 607-5730

210 Westchester Ave
White Plains, NY 10604
Phone (914) 681-3100

Networks

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

Interoperability endpoints

  • Direct secure messaging: jared.macklin.1@21260.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1205279247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WESTCHESTER AVE",
            "address_2": "STE N715",
            "city": "RYE BROOK",
            "state": "NY",
            "postal_code": "105731369",
            "telephone_number": "914-607-5730",
            "fax_number": "914-457-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 WESTCHESTER AVE",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "105772574",
            "telephone_number": "914-682-6466",
            "fax_number": "914-681-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKLIN",
        "first_name": "JARED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-09",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CT",
            "license": "62570",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "311211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Purchase, NY

Sources for this page

Verify at the official NPI Registry.