Individual provider Active NPI

Jason Keith Adams

  • Otology & Neurotology Physician
  • Jbsa Ft Sam Houston, TX
National Provider Identifier
1487155578
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otology & Neurotology PhysicianTaxonomy code 207YX0901X
License
321171 Issued in NY
Practice address
3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504
Phone
(210) 916-8040
Fax
(210) 916-8366
NPI assigned
Feb 23, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD-46986 IA
Otology & Neurotology Physician 207YX0901X 321171 NY Primary

Addresses

Primary practice location

3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504

Mailing address

3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504
Phone (210) 916-8040

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
I20230427000130 NY Practitioner - Otolaryngology 9133555295 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Otolaryngology CurrentSince Jul 12, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jun 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai Otolaryngology CurrentSince Jun 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 12, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients

Locations

7901 Broadway
Rm A119
Elmhurst, NY 11373
Phone (718) 334-3915

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 6

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": "1519344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1487155578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-8040",
            "fax_number": "210-916-8366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-8040",
            "fax_number": "210-916-8366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "JASON",
        "middle_name": "KEITH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-23",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IA",
            "license": "MD-46986",
            "primary": false
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "NY",
            "license": "321171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Ft Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.