Active NPI
Jansen Medical Services, P.C.
- Emergency Medicine Physician
- Suffern, NY
National Provider Identifier
1366035982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- JANSEN MEDICAL SERVICES, P.C.
- Practice address
- 255 Lafayette Ave
Suffern, NY 10901-4812 - Phone
- (845) 368-5000
- NPI assigned
- Feb 15, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Derik K King, MD
- Title
- Authorized Official
- Phone
- (800) 893-9698
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | Primary | ||
| Physician Assistant | 363A00000X | |||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
255 Lafayette Ave
Suffern, NY 10901-4812
Mailing address
200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (337) 609-2768
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613347200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1613347200000",
"number": "1366035982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 CORPORATE BLVD",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705083870",
"telephone_number": "337-609-2768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 LAFAYETTE AVE",
"city": "SUFFERN",
"state": "NY",
"postal_code": "109014812",
"telephone_number": "845-368-5000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JANSEN MEDICAL SERVICES, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2021-02-15",
"last_updated": "2021-02-15",
"certification_date": "2021-02-15",
"status": "A",
"authorized_official_last_name": "KING",
"authorized_official_first_name": "DERIK",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "800-893-9698",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Suffern, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.