Kimberly A Jackus, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

186183-1 Issued in NY

Practice address

3127 41St St
Astoria, NY 11103-3901

Phone

(718) 721-6989

NPI assigned

Jun 23, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• James Marc Schlesinger MD PC

  • Anesthesiology Physician
  • Toms River, NJ
  • NPI 1700265915
  Medicare reassignment NPD
• Leonid Lamper MD PC

  • Anesthesiology Physician
  • Elmwood Park, NJ
  • NPI 1659687903
  Medicare reassignment NPD
• Lenox Hill Medical Anesthesiology, PLLC

  • Specialist
  • New York, NY
  • NPI 1447256573
  NPD (past)
• Pain Management Institute PA

  • Anesthesiology Physician
  • Elmwood Park, NJ
  • NPI 1780989087
  NPD (past)

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378339200000",
    "number": "1558367540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 280",
            "city": "MILLTOWN",
            "state": "NJ",
            "postal_code": "088500280",
            "telephone_number": "800-738-1659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3127 41ST ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111033901",
            "telephone_number": "718-721-6989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKUS",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-23",
        "last_updated": "2013-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "186183-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02111686",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dina Issa
• Monica Iverson, APRN, WHNP-BC
• Rupa Lakshmi Iyengar-Kapuganti, MD
• Michelle Annmarie Jackson Petersen, NP
• Latayvia Sheris Jackson
• Arthur Jacobs, SLP
• Asad Jafary
• Czarinabelle Jaffery
• Dianne Jaggon, RPA
• Kris Jaho, PHARMD

• Anesthesiology Physician in Astoria, NY
• Providers in Astoria, NY by specialty
• Anesthesiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.