Active NPI
Jack Robert Cohen, M.D.
- Internal Medicine Physician
- North Miami Beach, FL
National Provider Identifier
1295788008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME0030214
- Practice address
- 909 N Miami Beach Blvd
Suite 302
North Miami Beach, FL 33162-3712 - Phone
- (305) 949-2491
- Fax
- (305) 949-1021
- NPI assigned
- May 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME0030214 | FL | Primary |
| Gastroenterology Physician | 207RG0100X | ME0030214 | FL |
Addresses
Primary practice location
909 N Miami Beach Blvd
Suite 302
North Miami Beach, FL 33162-3712
Mailing address
909 N Miami Beach Blvd
Suite 302
North Miami Beach, FL 33162-3712
Phone (305) 949-2491
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0422800001 | Other | FL | CIGNA |
| 4311898 | Other | FL | AETNA PPO |
| 55060 | Other | FL | JMH |
| P1528001 | Other | FL | OXFORD |
| 020463 | Other | FL | NHP |
| S843801 | Other | FL | CAREPLUS |
| 18693 | Other | DC | WELLCARE |
| 2622370 | Other | FL | AETNA |
| 203994 | Other | FL | AVMED |
| 92846 | Other | FL | BCBS FL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0030214 | FL | MD | Gastroenterology Physician |
Networks
- Optimum HealthCare HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208476800000",
"number": "1295788008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 N MIAMI BEACH BLVD",
"address_2": "SUITE 302",
"city": "NORTH MIAMI BEACH",
"state": "FL",
"postal_code": "331623712",
"telephone_number": "305-949-2491",
"fax_number": "305-949-1021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 N MIAMI BEACH BLVD",
"address_2": "SUITE 302",
"city": "NORTH MIAMI BEACH",
"state": "FL",
"postal_code": "331623712",
"telephone_number": "305-949-2491",
"fax_number": "305-949-1021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COHEN",
"first_name": "JACK",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2008-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME0030214",
"primary": true
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "FL",
"license": "ME0030214",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "0422800001",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "4311898",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JMH",
"identifier": "55060",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P1528001",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NHP",
"identifier": "020463",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREPLUS",
"identifier": "S843801",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "18693",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2622370",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "203994",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS FL",
"identifier": "92846",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Miami Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.