Individual provider Active NPI

Patricia Jack

  • Doula
  • Brooklyn, NY
National Provider Identifier
1235029034
Registry record updated Jul 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DoulaTaxonomy code 374J00000X
License
1454916
Practice address
2500 Bedford Ave Apt 4F
Brooklyn, NY 11226-7079
Phone
(718) 650-9303
NPI assigned
Jul 4, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Doula 374J00000X 1454916 Primary

Addresses

Primary practice location

2500 Bedford Ave Apt 4F
Brooklyn, NY 11226-7079

Mailing address

2500 Bedford Ave Apt 4F
Brooklyn, NY 11226-7079
Phone (718) 650-9303

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1751587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751587200000",
    "number": "1235029034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 BEDFORD AVE APT 4F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112267079",
            "telephone_number": "718-650-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 BEDFORD AVE APT 4F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112267079",
            "telephone_number": "718-650-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACK",
        "first_name": "PATRICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-04",
        "last_updated": "2025-07-04",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": null,
            "license": "1454916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.