Individual provider Active NPI

Michael Jerome, DO

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1306164967
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
W1174 Issued in TX
Practice address
2360 Gus Thomasson Rd
Dallas, TX 75228-3005
Phone
(214) 301-7071
NPI assigned
May 6, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X W1174 TX Primary

Addresses

Primary practice location

2360 Gus Thomasson Rd
Dallas, TX 75228-3005

Mailing address

PO Box 746079
Atlanta, GA 30374-6079
Phone (646) 680-2888

Other practice location 1

4337 Broadway
New York, NY 10033
Phone (212) 568-6300

Other practice location 2

4337 Broadway
New York, NY 10033
Phone (212) 568-6300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 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
I20170918001097 NY Practitioner - Internal Medicine 4688995632 Reassigns benefits to 2 organizations
I20251027000757 TX Practitioner - Osteopathic Manipulative MedicinePractitioner - Internal Medicine 4688995632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Rowan University School of Osteopathic Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Street Health of Texas PLLCGroup PAC ID 2163843038, 103 clinicians

Practice addresses (Care Compare)

2360 Gus Thomasson Rd
Dallas, TX 75228-3005
Phone (314) 301-7071

79 E Post Rd
White Plains, NY 10601-5008
Phone (914) 681-1128

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
W1174TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advantagecare Physicians PC Internal Medicine CurrentSince Aug 1, 2017 Accepting new patients
White Plains Physician Services PC Internal Medicine CurrentSince Sep 3, 2024 Accepting new patients
Oak Street Health of Texas, PLLC Internal Medicine CurrentSince Nov 10, 2025 Accepting new patients
Advantagecare Physicians PC CurrentSince Aug 1, 2017 Accepting new patients

Locations

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

185 Kisco Ave
Ste 300
Mount Kisco, NY 10549
Phone (914) 242-2020

55 Water St
Fl 2
New York, NY 10041

4337 Broadway
New York, NY 10033
Phone (212) 523-5201

79 E Post Rd
White Plains, NY 10601
Phone (914) 849-3488

2360 Gus Thomasson Rd
Dallas, TX 75228
Phone (314) 301-7071

4115 E Lancaster Ave
Fort Worth, TX 76103
Phone (817) 796-7370

3500 Little York Rd
#A5
Houston, TX 77093
Phone (281) 707-7358

2115 S Broadway Ave
Tyler, TX 75701
Phone (903) 907-7002

Networks

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

Interoperability endpoints

  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4

Organizations & group practices 4

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 1

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": "1273104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1306164967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746079",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746079",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 GUS THOMASSON RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752283005",
            "telephone_number": "214-301-7071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4337 Broadway",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10033",
            "country_code": "US",
            "telephone_number": "212-568-6300",
            "fax_number": "212-544-5094",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4337 Broadway",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10033",
            "country_code": "US",
            "telephone_number": "212-568-6300",
            "fax_number": "212-544-5094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEROME",
        "first_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-06",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "W1174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.