Jacob White, MD

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

264822 Issued in NY

Practice address

1264 Saint Nicholas Ave
New York, NY 10033-7263

Phone

(347) 532-1845

Fax

(718) 301-1099

NPI assigned

Apr 4, 2010

Last updated

Nov 29, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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, IL, NJ, TX4 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 4

Specialty

Interventional Radiology

Education

Georgetown University School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pelham Pkwy Professional Medical Services of New York LLCGroup PAC ID 9335404557, 10 clinicians

Pelham Pkwy Medical of New York LLCGroup PAC ID 4082976386, 23 clinicians

Valley Stream Professional Medical Services, LLCGroup PAC ID 0840517710, 2 clinicians

USA Vein Clinics of New Jersey LLCGroup PAC ID 1355585191, 9 clinicians

USA Vascular Center of New Jersey LLCGroup PAC ID 1759709371, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations (25 of 84)

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.

• Pelham Pkwy Medical of New York LLC

  • Vascular Surgery Physician
  • Bronx, NY
  • NPI 1285156067
  Medicare reassignment Care Compare group NPD
• Pelham Pkwy Professional Medical Services of New York LLC

  • Vascular Surgery Physician
  • Bronx, NY
  • NPI 1063926962
  Medicare reassignment Care Compare group NPD
• USA Vascular Center of New Jersey LLC

  • Vascular Surgery Physician
  • Orange, NJ
  • NPI 1437701729
  Medicare reassignment Care Compare group NPD
• Valley Stream Professional Medical Services, LLC

  • Vascular Surgery Physician
  • Valley Stream, NY
  • NPI 1356739668
  Medicare reassignment Care Compare group
• USA Vein Clinics of New Jersey LLC

  • Specialist
  • Tinton Falls, NJ
  • NPI 1245663236
  Medicare reassignment Care Compare group
• Astoria Medical of New York, LLC

  • Vascular Surgery Physician
  • Astoria, NY
  • NPI 1790156982
  Medicare reassignment NPD
• Bushwick Professional Medical Services of New York LLC

  • Vascular Surgery Physician
  • Brooklyn, NY
  • NPI 1003393299
  Medicare reassignment NPD
• Corona Medical of New York LLC

  • Vascular Surgery Physician
  • Jackson Heights, NY
  • NPI 1437691920
  Medicare reassignment NPD
• Foxhurst Professional Medical Services of New York LLC

  • Vascular Surgery Physician
  • Bronx, NY
  • NPI 1366956260
  Medicare reassignment NPD
• Hudson Valley Lithotripsy Associates, P.C.

  • Urology Physician
  • Hartsdale, NY
  • NPI 1437242781
  Medicare reassignment NPD
• Integrated Medical Professionals PLLC

  • Urology Physician
  • Lake Success, NY
  • NPI 1346203536
  Medicare reassignment NPD
• Jamaica Queens Medical of New York LLC

  • Vascular Surgery Physician
  • Jamaica, NY
  • NPI 1366962961
  Medicare reassignment NPD

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

{
    "created_epoch": "1270339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1386969210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600650032",
            "telephone_number": "224-318-0118",
            "fax_number": "847-919-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1264 SAINT NICHOLAS AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100337263",
            "telephone_number": "347-532-1845",
            "fax_number": "718-301-1099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Community Dr",
            "address_purpose": "LOCATION",
            "city": "Manhasset",
            "state": "NY",
            "postal_code": "110303816",
            "country_code": "US",
            "telephone_number": "516-562-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-04",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "264822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Handel White, MD
• Harrison Nicholas White
• Harvey Lee White, M.D.
• Hayley White
• Holly Lynn White, CNM
• Jason James White, M.D.
• Jay Brandon Wilson White, MHC-I
• Jess White, MA, LCAT, ATR-BC
• Jessica Mary-Kathleen Ayanna White, PA-C
• John White, CASAC-T

• Vascular & Interventional Radiology Physician in New York, NY
• Providers in New York, NY by specialty
• Vascular & Interventional Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.