Individual provider Active NPI

Ricardo Armando Jacquez, M.D.

  • Surgical Critical Care Physician
  • Mineola, NY
National Provider Identifier
1366708877
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
296062 Issued in NY
Practice address
173 Mineola Blvd Ste 401
Mineola, NY 11501-2555
Phone
(516) 663-1145
NPI assigned
Apr 9, 2012
Last updated
May 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 296062 NY
Surgical Critical Care Physician 2086S0102X 296062 NY Primary

Addresses

Primary practice location

173 Mineola Blvd Ste 401
Mineola, NY 11501-2555

Mailing address

PO Box 520467
Flushing, NY 11352-0467
Phone (832) 413-3077

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rjacquez337142@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191219002746 NY Practitioner - General Surgery 7214927375 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

33 -57 Harrison St
Johnson City, NY 13790-2107
Phone (607) 763-6101

54 Main St
Candor, NY 13743-1619
Phone (607) 659-7272

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
296062NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jan 1, 2020 Accepting new patients
New York University Surgery CurrentSince Jan 1, 2020 Accepting new patients

Locations

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

700 Stewart Ave
Ste 200202
Garden City, NY 11530
Phone (516) 663-1430

173 Mineola Blvd
Ste 401
Mineola, NY 11501
Phone (516) 663-1145

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Interoperability endpoints

  • Direct secure messaging: rjacquez337142@nyumc.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1366708877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 520467",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113520467",
            "telephone_number": "832-413-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 MINEOLA BLVD STE 401",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012555",
            "telephone_number": "516-663-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACQUEZ",
        "first_name": "RICARDO",
        "middle_name": "ARMANDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-09",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "296062",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NY",
            "license": "296062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rjacquez337142@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "173 Mineola Blvd Ste 401",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115012555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.