Organization Active NPI

William V Jacobson MD PC

  • Family Medicine Physician
  • White Plains, NY
National Provider Identifier
1417106527
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WILLIAM V JACOBSON MD PC
Practice address
311 North St Ste 202
White Plains, NY 10605-2232
Phone
(914) 949-1244
Fax
(914) 684-1336
NPI assigned
Sep 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Authorized official

Name
William JacobsonNPI 1801803556
Title
President
Phone
(914) 949-1244

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

311 North St Ste 202
White Plains, NY 10605-2232

Mailing address

311 North St Ste 202
White Plains, NY 10605-2232
Phone (914) 949-1244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090317000437 NY Part B Supplier - Clinic/Group Practice 7214986330 Receives reassigned benefits from 1 practitioner
Practice locations: White Plains, NY

National Provider Directory

National Provider Directory

Locations

311 North St
Ste 202
White Plains, NY 10605
Phone (914) 494-1244

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681257600000",
    "number": "1417106527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 NORTH ST STE 202",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106052232",
            "telephone_number": "914-949-1244",
            "fax_number": "914-684-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 NORTH ST STE 202",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106052232",
            "telephone_number": "914-949-1244",
            "fax_number": "914-684-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM V JACOBSON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-12",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-949-1244"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.