Active NPI
Jerald L Cohen, MD
- Cardiovascular Disease Physician
- Mineola, NY
National Provider Identifier
1518953736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 121214
- Practice address
- 120 Mineola Blvd
Suite 500
Mineola, NY 11501-4073 - Phone
- (516) 663-4481
- Fax
- (516) 663-2054
- NPI assigned
- Sep 22, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 121214 | NY | Primary |
Addresses
Primary practice location
120 Mineola Blvd
Suite 500
Mineola, NY 11501-4073
Mailing address
120 Mineola Blvd
Suite 500
Mineola, NY 11501-4073
Phone (516) 663-4481
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02433498 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 121214 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423008000000",
"number": "1518953736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 MINEOLA BLVD",
"address_2": "SUITE 500",
"city": "MINEOLA",
"state": "NY",
"postal_code": "115014073",
"telephone_number": "516-663-4481",
"fax_number": "516-663-2054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 MINEOLA BLVD",
"address_2": "SUITE 500",
"city": "MINEOLA",
"state": "NY",
"postal_code": "115014073",
"telephone_number": "516-663-4481",
"fax_number": "516-663-2054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COHEN",
"first_name": "JERALD",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-22",
"last_updated": "2015-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NY",
"license": "121214",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02433498",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mineola, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.