Individual provider Active NPI

Jinah Choi Pacheco

  • Specialist
  • Bronx, NY
National Provider Identifier
1467714725
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2213558 Issued in NY
Practice address
2510 Westchester Ave
Suite 102
Bronx, NY 10461-3512
Phone
(718) 597-5558
Fax
(718) 823-5494
NPI assigned
Jun 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2213558 NY Primary

Addresses

Primary practice location

2510 Westchester Ave
Suite 102
Bronx, NY 10461-3512

Mailing address

1 Samantha Way
Floor 1
Bronx, NY 10465-2951
Phone (917) 583-9102

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

State licenses

LicenseStateTypeSpecialty
2213558NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Theracare 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": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1467714725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SAMANTHA WAY",
            "address_2": "FLOOR 1",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104652951",
            "telephone_number": "917-583-9102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 WESTCHESTER AVE",
            "address_2": "SUITE 102",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104613512",
            "telephone_number": "718-597-5558",
            "fax_number": "718-823-5494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "JINAH",
        "middle_name": "CHOI",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "2213558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.