Active NPI
Stanley Jacob, MD
- Pediatrics Physician
- New City, NY
National Provider Identifier
1366540528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 241646
- Practice address
- 180 Phillips Hill Rd
Suite 4a
New City, NY 10956-4132 - Phone
- (845) 499-2339
- Fax
- (845) 499-2340
- NPI assigned
- Sep 20, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 241646 | NY | Primary |
Addresses
Primary practice location
180 Phillips Hill Rd
Suite 4a
New City, NY 10956-4132
Mailing address
147 Primrose Dr
New Hyde Park, NY 11040-2115
Phone (718) 490-1280
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 241646 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Helping Kids Pediatrics PLLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302134400000",
"number": "1366540528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 PRIMROSE DR",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110402115",
"telephone_number": "718-490-1280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 PHILLIPS HILL RD",
"address_2": "SUITE 4A",
"city": "NEW CITY",
"state": "NY",
"postal_code": "109564132",
"telephone_number": "845-499-2339",
"fax_number": "845-499-2340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "STANLEY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2011-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "241646",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.