Frederick David Jacques, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

324426 Issued in NY

Practice address

111 E 210TH St
Bronx, NY 10467-2401

Phone

(718) 920-4321

NPI assigned

Apr 2, 2019

Last updated

Oct 31, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

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.

• North Shore - Lij Anesthesiology, PC

  • Anesthesiology Physician
  • Chappaqua, NY
  • NPI 1417401266
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Staten Island University Hospital

  • General Acute Care Hospital
  • Staten Island, NY
  • NPI 1407877137
  Care Compare affiliation

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1326500034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACQUES",
        "first_name": "FREDERICK",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "324426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Giselle D Jaconia, M.D.
• Andrea Jacovacci
• Jacqueline F. Noboa D.P.M.
• Latchmi Jacqueline, LMSW
• Carline Jacques, LMHC
• Olga Josephine Jacques
• Roger Fils Jacques, M.D.
• Stacey Jacques, SOCIAL WORKER
• Rilenne Jacquet
• Preeti Dineshrao Jadhav, M.D.

• Anesthesiology Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Anesthesiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.